• Title/Summary/Keyword: Iatrogenic effect

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The Effect of Botulinum Toxin on an Iatrogenic Sialo-Cutaneous Fistula

  • Hong, Seung Eun;Kwon, Jung Woo;Kang, So Ra;Park, Bo Young
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.237-239
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    • 2016
  • A sialo-cutaneous fistula is a communication between the skin and a salivary gland or duct discharging saliva. Trauma and iatrogenic complications are the most common causes of this condition. Treatments include aspiration, compression, and the administration of systemic anticholinergics; however, their effects are transient and unsatisfactory in most cases. We had a case of a patient who developed an iatrogenic sialo-cutaneous fistula after wide excision of squamous cell carcinoma in the parotid region that was not treated with conventional management, but instead completely resolved with the injection of botulinum toxin. Based on our experience, we recommend the injection of botulinum toxin into the salivary glands, especially the parotid gland, as a conservative treatment option for sialo-cutaneous fistula.

Non-surgical treatment of hemorrhagic shock caused by rupture of iatrogenic pseudoaneurysm (의인성 가성낭종 파열에 의한 출혈성 쇽의 비수술적 치료)

  • Kim, Soon Young;Kim, Tae Jun;Na, Seong Kyun;Park, Seung Ah;Jung, Dong Min;Kim, Yong Kyun;Jo, Sang-Ho
    • 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.

Removal of a broken needle using three-dimensional computed tomography: a case report

  • Kim, Jin-Ha;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.251-253
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    • 2013
  • Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

Bone-Preserving Decompression Procedures Have a Minor Effect on the Flexibility of the Lumbar Spine

  • Costa, Francesco;Ottardi, Claudia;Volkheimer, David;Ortolina, Alessandro;Bassani, Tito;Wilke, Hans-Joachim;Galbusera, Fabio
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.680-688
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    • 2018
  • Objective : To mitigate the risk of iatrogenic instability, new posterior decompression techniques able to preserve musculoskeletal structures have been introduced but never extensively investigated from a biomechanical point of view. This study was aimed to investigate the impact on spinal flexibility caused by a unilateral laminotomy for bilateral decompression, in comparison to the intact condition and a laminectomy with preservation of a bony bridge at the vertebral arch. Secondary aims were to investigate the biomechanical effects of two-level decompression and the quantification of the restoration of stability after posterior fixation. Methods : A universal spine tester was used to measure the flexibility of six L2-L5 human spine specimens in intact conditions and after decompression and fixation surgeries. An incremental damage protocol was applied : 1) unilateral laminotomy for bilateral decompression at L3-L4; 2) on three specimens, the unilateral laminotomy was extended to L4-L5; 3) laminectomy with preservation of a bony bridge at the vertebral arch (at L3-L4 in the first three specimens and at L4-L5 in the rest); and 4) pedicle screw fixation at the involved levels. Results : Unilateral laminotomy for bilateral decompression had a minor influence on the lumbar flexibility. In flexion-extension, the median range of motion increased by 8%. The bone-preserving laminectomy did not cause major changes in spinal flexibility. Two-level decompression approximately induced a twofold destabilization compared to the single-level treatment, with greater effect on the lower level. Posterior fixation reduced the flexibility to values lower than in the intact conditions in all cases. Conclusion : In vitro testing of human lumbar specimens revealed that unilateral laminotomy for bilateral decompression and bone-preserving laminectomy induced a minor destabilization at the operated level. In absence of other pathological factors (e.g., clinical instability, spondylolisthesis), both techniques appear to be safe from a biomechanical point of view.

Clinical Study on the Case of Patient with Iatrogenic Brachial Plexus Injury after Cervical Lymph Node Biopsy: A Case Report (경부림프절 생검 후 발생한 상완신경총 손상 환자의 한방치료 1례: 증례 보고)

  • Kim, Yu Ri;Noh, Seung Hee;Kim, Kun Hyung;Yang, Gi Young;Lee, Byung Ryul;Kim, Jae Kyu
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.219-226
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    • 2013
  • Objectives : The purpose of this study is to report the effect of Korean medicine treatment on a patient with brachial plexus injury. Methods : The patient with symptoms of pain and dysesthesia on right forearm and hand was treated with acupuncture treatment, herbal medicine, moxibustion and physical treatment. Improvement of the patient's symptoms was evaluated by Hepatic dullness sound, NRS, VAS, SF-36 bodily pain, grip strength. Results : After 42 days of treatment, NRS score significantly decreased. VAS score, SF-36 bodily pain and grip strength showed moderate improvement. Conclusions : This results suggest that Korean medicine treatment may be effective in reducing the symptoms of brachial plexus injury.

A Longitudinal Study on Salivary Microorgnisms and Immunoglobulin A after Delivery of Fixed Orthodontic Appliances (고정식 교정 장치물 장착후 타액내 미생물과 면역 글로블린 A의 변화)

  • 이현경;이광호;이승우
    • Journal of Oral Medicine and Pain
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    • v.23 no.2
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    • pp.109-117
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    • 1998
  • Fixed orthodontic appliances for the treatment of malocclusion has iatrogenic side effect such as demineralization of enamel, gingivitix and gingival hyperplasia. The purpose of this study is to longitudinally investigate the salivary microorganisms and immunoglobulin A after delivery of fixed orthodontic appliances for 10 months. Eight orthodontic patients were included in this study and the author has investigated the numbers of general bacteria, Streptococcus mutans Staphylococcus aureus and concentration of immunoglobulin A from unstimulated whole saliva. The author examined these parameters at prebracketing, 1 month after, 4 months after, 7 months after and 10 months after delivery of fixed orthodontic appliances. The obtained results were as follows : There were significant increases in the number of salivary general bacteria, Streptococcus mutans and Staphylococcus aureus after delivery of fixed orthodontic appliances The numbers of general bacteria were significantly increased at 1 month after (p<005), 4 months after (p<0.05), 7 months after (p<0.01), compared with prebracketing. However it showed no difference at 10 month after compared with 7 months after bracketing. The Numbers of Staphylococcus aureus were significantly increased at 1 month after (p<0.05), 4 months after(p<0.01), 7 month(p<0.01), compared with prebracketing. However it showed decreasing pattern at 10 months after compared with 7 months after bracketing. There was no significant difference in the concentration of immunoglobulin A after delivery of fixed orthodontic appliances.

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Complex Korean Medical Treatment of Postoperative Ankylosis in Septic Arthritis of the Knee: A Case Report (화농성 무릎관절염의 수술 후 관절강직에 대한 한의복합치료: 증례보고)

  • Woo, Hyeon-Jun;Han, Yun-Hee;Lee, Jung-Han;Ha, Won-Bae
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.161-169
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    • 2022
  • A 50-year-old Korean male tour guide without any medical or family history complained of left knee pain. After receiving umbilical cord blood injection treatment, the pain gradually worsened. After being diagnosed with septic arthritis in the left knee, arthroscopic lavage, debridement, antibiotic treatment, and routine rehabilitation therapy were performed, but the symptoms persisted. In the hospital, acupuncture, pharmacopuncture, acupotomy, Chuna manual therapy, and cupping therapy were performed in addition to the usual treatment for 59 days. To evaluate the patient's improvement, the numeric rating scale, EuroQol 5-dimension, pain disability index, and Lysholm knee scoring system were used. After treatment, the symptoms improved in all assessment tools, swelling, and range of motion of the joint. Through this study, it was found that complex Korean medical therapies may be effective for postoperative ankylosis in septic arthritis of the knee, and further studies are needed to clarify the therapeutic effect.

Effect of micro-osteoperforations on external apical root resorption: A randomized controlled trial

  • Shahrin, Azaitun Akma;Ghani, Sarah Haniza Abdul;Norman, Noraina Hafizan
    • The korean journal of orthodontics
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    • v.51 no.2
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    • pp.86-94
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    • 2021
  • Objective: This study aimed to investigate the effect of micro-osteoperforations (MOPs) on external apical root resorption (EARR) during the initial orthodontic alignment phase of maxillary anterior crowding. Methods: Thirty patients (25 females, 5 males; mean age, 22.66 ± 3.27 years) who presented with moderate crowding of the upper labial segment and underwent extraction-based fixed appliance treatment were recruited. They were randomly allocated to receive adjunctive therapy with MOPs (n = 15) or treatment with fixed appliances only (control group; n = 15). EARR was measured from long-cone periapical radiographs taken at the start and the sixth month of treatment. A correction factor for the enlargement difference was used to calculate EARR. Data were analyzed with descriptive statistics and repeated-measures analysis of variance. Results: The mean root lengths of 168 teeth were measured and showed no statistically significant difference (p > 0.05) after six months of fixed appliance treatment in the MOP (mean difference [MD] = 0.13 mm; 95% confidence interval [CI] = -0.10-0.35) and control group (MD = 0.14 mm; 95% CI = -0.10-0.37). Most of the roots in the MOP and control groups (42.86% and 52.38%, respectively) showed only mild resorption. Less than 8% of the roots in both groups (7.14% in the MOP group and 4.76% in the control group) showed moderate resorption. Conclusions: Acceleration of orthodontic tooth movement with adjunctive MOPs therapy during the alignment phase does not exacerbate EARR in patients with moderate crowding of the upper labial segment in comparison with controls.

Efficacy of Transcatheter Arterial Embolization with N-Butyl Cyanoacrylate in Acute Bleeding Patient (급성 출혈 환자에서 N-Butyl Cyanoacrylate를 이용한 경도관 동맥색전술의 유용성)

  • Jae, Hwan Jun;Kim, Sang Youn;Lee, Eui Jung;Lee, Whal;Suh, Gil Joon
    • Journal of Trauma and Injury
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    • v.18 no.2
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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.

A Way to Avoid Muscular Fibrosis in the First Dorsal Interosseous Muscle after Acupuncture Injection Therapy

  • Wong, Yiu Ming
    • Journal of Pharmacopuncture
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    • v.20 no.3
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    • pp.227-229
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    • 2017
  • Fibrosis of skeletal muscle following acupuncture is an iatrogenic disorder. The present case illustrates a patient with a unilateral fibrotic formation on a thumb muscle after acupuncture injection therapy with red sage. The patient in the present case was a counter-terrorism police officer with right-handedness; he noted a palpable nodule three months after injection therapy at his left first dorsal interosseous in which the acupuncture point LI4 (He Gu) is located. He also found a reduction in the strength of his left pinch grip that noticeably affected his left handgun marksmanship. However, being ambidextrous in single-hand pistol shooting is an essential requirement for counter-terrorism police officers. Based on the patient's medical history and claims, no underlying disease or trauma was found to be associated with his current complaint. During physical examination, a fibrotic formation in his left first dorsal interosseous muscle was visualized by using diagnostic ultrasound; also, as confirmed with dynamometry, the strength of his left pinch grip was significantly lower than that of the right counterpart. Because acupuncture injection therapy has three components, antiseptic practices, the mechanical action of syringe insertion, and the pharmacological effect of the sterile herb extract, any one of the components may have contributed to the present adverse event. The first dorsal interosseous muscle is small in dimension and rather vascular; thus, it is not an ideal site for intramuscular injection. When a clinician needs to treat a patient by performing acupuncture at the LI4 acupoint and injecting a herbal extract simultaneously, the clinician should only mechanically stimulate the LI4 acupoint while injecting the herbal medicine into the LI14 (Bi Noe) acupoint on the same meridian, the LI14 acupoint being located in the distal portion of the deltoid muscle and being fairly close to the universally agreed upon site on the upper arm for safe administration of an injection.