• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.49-52
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• 2017

Subcutaneous facial emphysema after dental treatment is an uncommon complication caused by the invasion of high-pressure air; in severe cases, it can spread to the neck, mediastinum, and thorax, resulting in cervical emphysema, pneumomediastinum, and pneumothorax. The present case showed subcutaneous cervicofacial emphysema with pneumomediastinum after class V restoration. The patient was fully recovered after eight days of conservative treatment. The cause of this case was the penetration of high-pressure air through the gingival sulcus, which had a weakened gingival attachment. This case indicated that dentists should be careful to prevent subcutaneous emphysema during common dental treatments using a high-speed hand piece and gingival retraction cord.

• 대한후두음성언어의학회지
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• 제11권2호
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• pp.188-191
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• 2000

In thyroid and parathyroid surgery, damage to the recurrent laryngeal nerve(RLN) is the most common iatrogenic cause of vocal cord paralysis. Identification and preservation of the BLNs and meticulous technique can siginificantly decrease the incidence of this complication. We experienced one case of NRRLN in a patient with the parathyroid adenoma. During the dissection, there was no branch to be considered as RLN in tracheoesophageal groove. While searching for the RLN, We found a white structure coursing horizontally at the level of cricoid cartilage directly arising from the vagus nerve in the carotid sheath. That structure was nonrecurrent recurrent laryngeal nerve(NRRLN) and NRRLNs are exceedingly rare. Awareness of the possibility of NRRLN will prevent the surgeon from accidentally severing one if it is encountered during surgery.

• Journal of Chest Surgery
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• 제24권2호
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• pp.171-181
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• 1991

Result of St. Jude Medical valve replacement are presented in 106 patients who underwent operation from January 1985 through July 1989. The patient were 52 males and 56 females. Total 136 of St. Jude Medical valves were implanted; 91 in mitral position, 45 in aortic position. The hospital mortality rate was 5.7%o[6 patients] and the late mortality rate was 2.0%[2 patients]. The causes of death were low cardiac output in 5, iatrogenic right ventricular rupture in 1, heart failure in 1, ventricular arrhythmia in l. And, the causes of valve related complication were anticoagulant related hemorrhage in 5 patients[0.03% /patient-year] and thromboembolism[0.01% /patient-year] in 2 patients. In conclusion, the performance of the St. Jude Medical valve compare most favorably with other artificial valves. But it remains still hazards of mechanical prosthesis such as thromboembolism and anticoagulant related hemorrhage.

• Journal of Chest Surgery
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• 제46권3호
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• pp.223-225
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• 2013

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

• 대한치과의사협회지
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• 제55권8호
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• pp.565-573
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• 2017

Root canal perforations are defined as the communication between the pulp cavity, the periodontal tissue and alveolar bone. The occurrence of perforations during endodontic treatment is reported to range from 2.3%~12%, which is not a complication rarely happens. Perforations have iatrogenic or pathological etiologies that involve caries or resorption. It leads to inflammation and the destruction of periodontal fibers and alveolar bone, followed by periodontal defects. Mineral trioxide aggregate (MTA) is currently the most indicated material for repair of root perforation, because of its favorable biocompatibility and sealing ability. Using magnification with dental operating microscope enhance the accessibility and visibility to manage the root perforation. It is important to diagnose and repair perforations immediately if possible.

• Journal of Korean Neurosurgical Society
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• 제52권5호
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• pp.491-494
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• 2012

We report a rare complication of iatrogenic spinal intradural following minimally invasive extradural endoscopic procedues in the lumbo-sacral spines. To our knowledge, intradural cyst following epiduroscopy has not been reported in the literature. A 65-year-old woman with back pain related with previous lumbar disc surgery underwent endoscopic epidural neuroplasty and nerve block, but her back pain much aggravated after this procedure. Postoperative magnetic resonance imaging revealed a large intradural cyst from S1-2 to L2-3 displacing the nerve roots anteriorly. On T1 and T2-weighted image, the signal within the cyst had the same intensity as cerebrospinal fluid. The patient underwent partial laminectomy of L5 and intradural exploration, and fenestration of the cystic wall was accomplished. During operation, the communication between the cyst and subarachnoid space was not identified, and the content of the cyst was the same as that of cerebrospinal fluid. Postoperatively, the pain attenuated immediately. Incidental durotomy which occurred during advancing the endoscope through epidural space may be the cause of formation of the intradural cyst. Intrdural cyst should be considered, if a patient complains of new symptoms such as aggravation of back pain after epiduroscopy. Surgical treatment, simple fenestration of the cyst may lead to improved outcome. All the procedures using epiduroscopy should be performed with caution.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.207-211
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• 2011

Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.112-118
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• 2005

Background: N-Butyl Cyanoacrylate (NBCA) is a liquid embolic material that can be useful for transcatheter arterial embolization (TAE) of acute bleeding especially in patients with coagulopathy, because it does not depend on coagulation for its therapeutic effect. The aims of this study were to evaluate the clinical efficacy and safety of TAE with NBCA in acute bleeding patients. Methods: Between August 2003 and September 2004, TAE using NBCA for acute bleeding was performed in 23 patients (16 men, 7 women; mean age, 56.5years). The causes of bleeding were gastric ulcer (n=5), postoperative bleeding (n=4), post-biopsy bleeding (n=3), postpartum bleeding (n=3), duodenal ulcer (n=2), angiodysplasia (n=2), gastric lymphoma (n=1), iatrogenic injury (n=1), CMV gastritis (n=1), stab injury of the liver (n=1). TAE was performed using 1:3 mixtures of NBCA and iodized oil. The angiographic and clinical success rate, recurrent bleeding rate, procedure-related complication and clinical outcomes were evaluated. Results: The angiographic and clinical success rate was 100% and 91.3% (21/23), respectively. There was no serious ischemic complication. Recurrent bleeding occurred in 2 patients (8.7%) and they were managed with successful second TAE (n=1) and endoscopic treatment (n=1). Nine patients (39.1%) had coagulopathy at the time of TAE and clinical success rate in this group of patients was 88.9% (8/9). Conclusions: TAE with NBCA is highly effective and safe treatment modality for acute bleeding patients, especially when the patient has a coagulopathy.

• Tuberculosis and Respiratory Diseases
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• 제63권2호
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• pp.178-182
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• 2007

정맥 내 공기 색전은 조영제 주입과 관련된 합병증으로 알려져 있다. 대부분의 경우 색전된 공기의 양이 적고 증상이 없으나 대량의 공기 색전은 치명적일 수 있다. 저자들은 흉부 CT 촬영 중 조영제 주입과 관련하여 발생한 대량의 우심실 내 공기 색전과 보존적 치료로 후유증 없이 회복된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한후두음성언어의학회지
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• 제8권1호
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• pp.75-81
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• 1997

The clinical investigation was done in the 42 patients with bilateral vocal cord palsy who visited the otorhinolaryngologic department of the Yongdong Severance Hospital during the 10-year period between August 1986 to August 1996. On the sex and age distribution, the ratio of male to female patients was 2.8 : 1 and the age was evenly distributed and average was 46 years old. Of their chief complaints, dyspnea was the most common symptom. Among the position of the paralyzed vocal cords, paramedian position was most common. The most common causes of the bilateral vocal cord palsy was idiopathic Other causes include iatrogenic, prolonged intubation, head ＆ neck trauma, brain tumor, Myasthenia Gravis, and mediastinitis. Our treament results were as follows. Recovery rate of idiopathic bilateral vocal cord palsy was 77.7% and recovery period after bilateral vocal cord palsy was shortened remarkedly after use with steroid. We performed laser arytenoidectomy in patients with irreversible idiopathic vocal cord palsy, neural injury, and cricoarytenoid joint fixation. Decannualtion was possible to be carried out in 86% of the patients and none of complication except for 1 case of aspiration developed. Thus we concluded that it was meaningful surgical treatment of bilateral vocal cord palsy.