• Title/Summary/Keyword: Neck surgery

검색결과 2,993건 처리시간 0.036초

해면 정맥동 혈전증(Cavernous Sinus Thrombosis) 치험례 (CAVERNOUS SINUS THROMBOSIS : A CASE REPORT)

  • 장현석;장명진;김용관;김경원
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권4호
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    • pp.447-455
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    • 1995
  • Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

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새기형(鰓畸形, Branchial Anomalies) - 대한 소아외과학회 회원을 주 대상으로 한 전국 조사 - (Branchial Anomalies in Korea - A Survey by the Korean Association of Pediatric Surgeons -)

  • 박우현;권수인;김상윤;김성철;김신곤;김우기;김인구;김재억;김현학;박귀원;박영식;박주섭;송영택;안우섭;오남근;오수명;유수영;이남혁;이두선;이명덕
    • Advances in pediatric surgery
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    • 제2권2호
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    • pp.119-128
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    • 1996
  • The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients (43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(19) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50(78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.

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타질환과 동반된 애성 (Uncommon Causes of Hoarseness)

  • 윤희병;김미자;정대현;박승훈;박옥경;목정민;전승하;강주원
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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    • pp.8.2-8
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    • 1982
  • 애성이란 음성의 질적 변화를 의미하는 것으로 이는 후두의 가장 대표적인 주 증상이다. 애성의 원인으로는 현재까지 알려져 있는것만 해도 약50 여종이 있다고 하며 그중 virus에 의한 상기도 감염증이 가장 많은 비율을 차지하고 있는 것으로 알려져 있고, 후두결절 및 풀립, 후두마비, 후두암, 후두유두종, 후두결핵등의 순으로 발생하는 것으로 알려져 있다. 최근 저자들은 본원에 입원중인 환자로서 애성 때문에 본 이비인후과로 진찰의뢰된 환자중 비교적 보기드문 질환과 동반된 애성환자 4예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 증예1. 29세 남자로서 교통사고로 후두부에 외상을 입은후 1 달만에 애성이 발생. 후두경 소견상 좌측성대의 paramedian paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예2. 53세 남자로서 clonorchis sinensis로 일반외과에서 전신 삽관마취하에 choledochostomy를 시행한 6 일후에 애성이 발생. 후두경 소견상 좌측성대의 median paralysis가 인정되었음. 증예3. 56세 남자로서 Aortic Aneurysm으로 내과에 입원한 환자로 입원전 3개월부터 애성이 발생. 후두경 소견상 좌측성대의 intermediate position paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예4. 74세 남자로서 Bronchogenic Ca.로 내과에 입원중인 환자로 입원 3년전부터 애성이 발생. 후두경 소견상 우측성대의 paramedian paralysis가 인정되었음

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외측 연수 경색에 의해 발생한 중추성 수면 무호흡 환자의 자동-적응형 양압기를 사용하여 치료한 경험 (Case of Treatment Using Adaptive Servo-Ventilation in a Patient with Central Sleep Apnea after a Lateral Medullary Infarction)

  • 김대진;조재욱;김현우;최정수;문수진
    • 대한임상검사과학회지
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    • 제52권3호
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    • pp.278-283
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    • 2020
  • 중추성 수면 무호흡은 수면 중 상기도 저항이 없을 때 흉부와 복부의 호흡 노력 없이 10초 이상의 호흡부전을 보이는 것이 특징이다. 본 증례에서 뇌자기공명영상 확산 강조 영상검사를 통해 외측 연수 경색의 진단을 받은 환자가 수면다원검사를 통해 중추성 수면 무호흡 진단 기준에 미치지 못하는 호흡부전과 중추성 수면 무호흡이 관찰되었다. 호흡부전과 중추성 수면 무호흡에 대한 일차 치료는 CPAP을 사용하였다. CPAP을 사용한 후 수면다원검사와 이전의 수면다원검사를 비교한 결과 무호흡-저호흡 지수(42.5/hr→82.8/hr)와 각성 지수(21.7/hr→40.8/hr)는 악화되었다. 이에 이차 치료로 ASV를 사용하여 적정압력검사를 시행하였다. 이전의 수면다원검사와 비교한 결과 무호흡-저호흡 지수(42.5/hr→8.6/hr)가 상당히 호전되었다. 이러한 결과로 ASV는 중추성 수면 무호흡과 호흡부전에 대한 좋은 치료방법이 될 수 있다.

Decreased Expression of FADS1 Predicts a Poor Prognosis in Patients with Esophageal Squamous Cell Carcinoma

  • Du, Yong;Yan, Shu-Mei;Gu, Wan-Yi;He, Fan;Huang, Li-Yun;Li, Mei;Yuan, Yan;Chen, Ren-Hui;Zhong, Qian;Li, Man-Zhi;Li, Yong;Zeng, Mu-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.5089-5094
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    • 2015
  • FADS1 (fatty acid desaturase 1) plays a crucial role in fatty acid metabolism, and it was recently reported to be involved in tumorigenesis. However, the role of FADS1 expression in esophageal squamous cell carcinoma (ESCC) remains unknown. In the current study, we investigated the expression and clinical pathologic and prognostic significance of FADS1 in ESCC. Immunohistochemical analyses revealed that 58.2% (146/251) of the ESCC tissues had low levels of FADS1 expression, whereas 41.8% (105/251) exhibited high levels of FADS1 expression. In positive cases, FADS1 expression was detected in the cytoplasm of cells. Correlation analyses demonstrated that FADS1 expression was significantly correlated with tumor location (p=0.025) but not with age, gender, histological grade, tumor status, nodal status or TNM staging. Furthermore, patients with tumors expressing high levels of FADS1had a longer disease-free survival time (p<0.001) and overall survival time (p <0.001). Univariate and multivariate analyses revealed that, along with nodal status, FADS1 expression was an independent and significant predictive factor (p<0.001). In conclusion, our study suggested that FADS1 might be a valuable biomarker and potential therapeutic target for ESCC.

Cancers of the Young Population in Brunei Darussalam

  • Mohammad, Ibnu Ayyub;Bujang, Mas Rina Wati;Telisinghe, Pemasari Upali;Abdullah, Muhd Syafiq;Chong, Chee Fui;Chong, Vui Heng
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6357-6362
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    • 2014
  • Background: Globally, the overall incidence of cancer is increasing as a result of ageing populations and changing lifestyles. Cancer is one of the leading causes of death, especially in the developed nations. Cancers affecting the young population are generally considered uncommon. This study assessed the demography and trends of cancers of the young in Brunei Darussalam, a small and developing Southeast Asia nation. Materials and Methods: All patients diagnosed with cancers between 2000 and 2012 were identified from the cancer registry maintained by the State Histopathology Laboratory. Cancers of the young was defined as any cancers diagnosed under the age of 40 years. Demographic data and the type of cancers were collected and analysed using SPSS Statistics 17.0. Results: Among the 6,460 patients diagnosed with cancer over the study period, 18.7% (n=1,205) were categorized as young with an overall decline in the proportion from 26.6% in 2000 to 18.8% in 2012 (p<0.001 for trend). Among all cancers of the young, the most common systems affected were gynecological (24.1%), hematological/lymphatic (15.8%), subcutaneous/dermatological/ musculoskeletal (10.5%), breast (10.5%) and gastrointestinal (9.9%). Overall, among the different systems, neurological (54.9%) had the highest proportion of cancers of the young followed by gynecological/reproductive (30.6%), hematological/lymphatic (39.9%), endocrine (38.7%), subcutaneous/dermatological/ musculoskeletal (22.3%) and the head and neck region (20.1%). There was a female predominance (66.9%) and the incidence was significantly higher among the Malays (20.1%) and expatriates (25.1%) groups compared to the Chinese (10.7%) and indigenous (16.8%) groups (p<0.001 for trend). Conclusions: Cancers of the young (<40 years) accounted for almost a fifth of all cancers in Brunei Darussalam with certain organ systems more strongly affected. There was a female preponderance in all racial groups. Over the years, there has been a decline in the overall proportion of cancers of the young. Selective screening programs should nevertheless be considered.

Oral Squamous Cell Carcinoma and Associated Risk Factors in Jazan, Saudi Arabia: A Hospital Based Case Control Study

  • Quadri, Mir Faeq Ali;Alharbi, Fahd;Bajonaid, Amal Mansoor S;Moafa, Ibtisam Hussain Y;Sharwani, Abubakker Al;Alamir, Abdulwahab Hussain A
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4335-4338
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    • 2015
  • Background: Oral cancer is the third most common malignancy in Saudi Arabia, the highest incidence of which is reported from Jazan province. The objective of this study was to evaluate the association of various locally used substances, especially shamma, with oral cancer in the Jazan region of Saudi Arabia. Materials and Methods: A hospital-based case-control study was designed and patient records were scanned for histologically confirmed oral cancer cases. Forty eight patients who were recently diagnosed with oral cancer were selected as cases. Two healthy controls were selected for each observed case and they were matched with age (+/- 5 years) gender and location. Use of different forms of tobacco such as cigarettes, pipe-smoking and shamma (smokeless-tobacco) was assessed. Khat, a commonly used chewing substance in the community was also included. Descriptive analysis was first performed followed by multiple logistic regression (with and without interaction) to derive odds ratios (ORs) and 95% confidence interval (CIs). Results: Mean age of the study sample (56% males and 44% females) was 65.3 years. Multinomial regression analysis revealed that shamma use increased the odds of developing oral cancer by 29 times (OR=29.3; 10.3-83.1). Cigarette (OR=6.74; 2.18-20.8) was also seen to have an effect. With the interaction model the odds ratio increased significantly for shamma users (OR=37.2; 12.3-113.2) and cigarette smokers (OR=10.5; 2.88-3.11). Khat was observed to have negative effect on the disease occurrence when used along with shamma (OR=0.01; 0.00 - 0.65). Conclusions: We conclude that shamma, a moist form of smokeless tobacco is a major threat for oral cancer occurrence in the Jazan region of Saudi Arabia. This study gives a direction to conduct further longitudinal studies in the region with increased sample size representing the population in order to provide more substantial evidence.

DNA Ligase4 as a Prognostic Marker in Nasopharyngeal Cancer Patients Treated with Radiotherapy

  • Kim, Dong Hyun;Oh, Sung Yong;Kim, So Yeon;Lee, Seul;Koh, Myeong Seok;Lee, Ji Hyun;Lee, Suee;Kim, Sung-Hyun;Park, Heon Soo;Hur, Won Joo;Jeong, Jin Sook;Ju, Mi Ha;Seol, Young Mi;Choi, Young-Jin;Chung, Joo Seop;Kim, Hyo-Jin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10985-10989
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    • 2015
  • Background: The capability for DNA double-strand breaks (DSBs) repair is crucial for inherent radiosensitivity of tumor and normal cells. We have investigated the clinicopathologic significance of DNA repair gene expression in nasopharyngeal (NP) carcinoma. Materials and Methods: A total of 65 NP cancer patients who received radiotherapy were included. The immunopositivity to Ku 70, DNA-PKcs, MRN, RAD50, XRCC4, and LIG4 were examined in all tumor tissues. Results: The patients comprised 42 males and 23 females, with a median age of 56 years (range, 18-84). The expression levels of RAD50 (0,+1,+2,+3) were 27.7%, 32.3%, 21.5%, and 18.5%. LIG4 (${\pm}$) were 43.1% and 56.9% respectively. The 5-year OS rate of patients with LIG4 (${\pm}$) were 90% and 67.9%, respectively (p=0.035). The 5-year TTP rate of patients with LIG4 (${\pm}$) were 75.9%, 55.5%, respectively (P=0.039). Conclusions: Our results suggest the possibility of predicting the radiosensitivity of NP cancer by performing immunohistochemical analysis of LIG4.

Effect on bone formation of the autogenous tooth graft in the treatment of peri-implant vertical bone defects in the minipigs

  • Kim, Seok Kon;Kim, Sae Woong;Kim, Kyung Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제37권
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    • pp.2.1-2.9
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    • 2015
  • Background: The aim of this study was to evaluate the effect of autogenous tooth bone as a graft material for regeneration of bone in vertical bony defects of the minipigs. Material and Methods: Six minipigs were used in this study. Four molars were extracted in the right mandibular dentition and sent to the Korea Tooth Bank for fabrication of autogenous tooth bone. Ten days later, each extraction site was implanted with MS Implant Narrow Ridge $3.0{\times}10mm$ fixture (Osstem, Seoul, Korea) after standardized 2mm-sized artificial vertical bony defect formation. Pineappleshaped Root-On type autogenous tooth bones were applied to the vertical defects around the neck area of the posterior three fixtures and the fore-most one was not applied with autogenous bone as a control group. Each minipig was sacrificed at 4, 8, 12 weeks after fixture installation and examined radiologically and histologically. Histological evaluation was done under light microscope with Villanueva osteochrome bone staining with semi-quantitative histomorphometric study. Percentage of new bone over total area (NBF) and bone to implant contact (BIC) ratio were evaluated using digital software for area calculation. Result: NBF were $48.15{\pm}18.02%$, $45.50{\pm}28.37%$, and $77.13{\pm}15.30%$ in 4, 8, and 12 weeks, respectively for experimental groups. The control group showed $37.00{\pm}11.53%$, $32.25{\pm}26.99%$, and $1.33{\pm}2.31%$ in 4,8,12 weeks, respectively. BIC ratio were $53.08{\pm}19.82%$, $45.00{\pm}28.37%$, and $75.13{\pm}16.55%$ in 4,8,12 weeks, respectively. Those for the control groups were $38.33{\pm}6.43%$, $33.50{\pm}29.51%$, and $1.33{\pm}2.31%$ in 4, 8, 12 weeks, respectively. Conclusion: Autogenous tooth bone showed higher score than control group in NBF and BIC in all the data encompassing 4,8,12 weeks specimens, but statistically significant only 12 weeks data in both NBF and BIC.

3차원 두부영상의 기준좌표계 설정을 위한 연구: 1부 CT영상에서 3차원 계측점의 재현성 (Formulation of a reference coordinate system of three-dimensional (3D) head & neck images: Part I. Reproducibility of 3D cephalometric landmarks)

  • Park, Jae-Woo;Kim, Nam-Kug;Chang, Young-Il
    • 대한치과교정학회지
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    • 제35권5호
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    • pp.388-397
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    • 2005
  • 이 연구는 기존의 두부방사선사진에서 사용되었던 계측점들을 3차원으로 재구성한 CT자료에서 다시 정의하고, 그 점들의 재현도를 조사함으로써. 재현성이 높고 해부학적 특징을 잘 표현하는 점들을 제안하고자 시행하였다. 3차원 영상에서 상대적 좌표 값을 구하기 위해 어느 4점도 같은 평면에 존재하지 않는 7개의 고정점을 선정하여 기준 좌표계를 설정하였다. V works 4.0 (Cybermed inc., Seoul. Korea)을 이용하여 고정점과 1점 설정을 위한 volume model (voxel size=4*4*2, threshold value-639)을 형성한 후 계측점을 선택하였으며. 나머지 점들은 모두 volume mode의 MPR 창을 이용하여 선정하였다 이렇게 선정한 계측점을 V 녁ㅎㄷ교 (Cybermed Inc.. Seoul, Korsa)로 이출하여 각 점의 상대적 공간 좌표 값을 구하였다 모든 자료는 2주 간격으로 2번 측정한 후 재현도를 계산하였다 각 계측점의 재현도는 x축 $0.13\~1.24mm$, y축 $0.23\~1.53mm$, z축 $0.15\~1.81mm$로 유사한 범위를 보였다 재현도가 우수한 것은 고정점을 이용한 1점이며 봉합에 의해 정의되는 J점의 재현도가 비교적 낮게 나타났다.