• 제목/요약/키워드: Neck swelling

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Superior Vena Cava Syndrome -2 Bypass Graft Cases- (상공정맥 증후군 -Dacron & Nylon 환치수술 2예-)

  • 김정석
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.65-72
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    • 1969
  • Superior Vena Cava Syndrome: Dacron and Nylon graft between the left innominate vein and the right atrial appendage. Two cases with typical superior vena cave syndrome treated by by-pass graft between the left innominate vein and the right atrial apepndage were presented. One of them was a 58 year old farmer who suffered from marked swelling of the neck and upper half of body, the other was a 50 years old government employee who had acutely progressive symptoms of superior vena cave obstruction. Both of cases revealed that [1] cubitel venous pressure was markedly increased. [2] tumors were noted in the posterior mediastinum by laminography. [3] preoperative cavogram showed the occlusion of superior vena cava and marked collaterals. Dacron and Nylon graft were inserted between the left innominate vein and the right atrial appendage. Postoperatively, the symptoms were relieved markedly, showing edema free face and decreased cubital venous pressure. Postoperative cavogram showed patent graft. Histologically the first case was diagnosed as squamous cell carcinoma and the second as undifferentiated carcinoma, originated probably from bronchus. Total doses of 3150 r X-ray irradiation and 5000 mg of 5-FU were administered in each cases. The first case expired 11 months postoperatively without recurrence of superior vena cave obstruction symptom and the second case is living now without obstruction signs, 4 months after by-pass operation.

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Clear cell odontogenic carcinoma mimicking a cystic lesion: a case of misdiagnosis

  • Kim, Minkyu;Cho, Eunae;Kim, Jae-Young;Kim, Hyun Sil;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.4
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    • pp.199-203
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    • 2014
  • Clear cell odontogenic carcinoma (CCOC) is a rare jaw tumor that was classified as a malignant tumor of odontogenic origin in 2005 by the World Health Organization because of its aggressive and destructive growth capacity and metastasis to the lungs and lymph nodes. We report a case of a 66-year-old female who had swelling, incision and drainage history and a well-defined unicystic radiolucent lesion that was comparable to a cystic lesion. At first, the patient received decompression, and the lesion size decreased. Three months after decompression, cyst enucleation was performed. The pathologic result indicated that the lesion was CCOC. In this report we emphasize that patients with painful cystic lesions in addition to jaw enlargement and loosening teeth should be considered for the possibility of malignancy.

Lymphocytoma cutis: diagnostic enigma for the maxillofacial surgeon

  • Kale, Tejraj P.;Singh, Arjun Gurmeet;Shah, Pushpak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.379-382
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    • 2016
  • Cutaneous lymphoid hyperplasia (CLH) is a cutaneous pseudolymphoma with a worldwide distribution, equally affecting all races and ethnic groups. Due to its vast array of characteristics, it is most often missed in the differential diagnosis of firm to soft lumps on the head and neck. A systematic approach to the workup and diagnosis along with treatment of such lesions is discussed in this article. A 20-year-old Asian Indian female presented to our Oral and Maxillofacial unit with a lump on the left side of her forehead for 1 month. Local examination revealed a $2.5{\times}3.0cm^2$, well circumscribed swelling over the left para median region that was firm to doughy and non-tender. There was no other significant finding on general examination. Excisional biopsy of the lesion was performed, followed by histopathologic processing. The general etiology, pathogenesis, clinical presentation, differential diagnosis, clinical course, prognosis, treatment, and prevention have been discussed in line with the recent modalities of diagnosis and treatment of CLH. Due to the overlapping clinical and histological characteristics of CLH with many other lesions, it is important to consider this lesion in the differential diagnosis of cutaneous lesions.

Descending Necrotizing Mediastinitis Caused by Yeast -A case report- (이스트에 의한 하행 괴사성 종격동염 -치험 1예-)

  • 윤영철;김성룡;전희재;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.386-389
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    • 2004
  • Descending nectorizing mediastinitis (DNM). represents a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce the high morbidity mortality associated with this disease. Intr. avenous broad-spectrum antibiotic therapy alone is not efficient without adequate surgical drainage of the cervical and mediastinal collections, extensive debridement and excision of necrotic tissue, and wide mediastino-pleural irrigation. A 38-year-old man admitted via emergency room with painful left neck swelling and uncontrolled high fever. Chest computed tomogram showed left paratracheal abscess descending into the superior and anterior mediastinum. Transcervical mediastinal drainage was performed with 26 Fr. chest tube and left paratracheal drainage was performed with Penrose drain in urgency. Culture and sensitivity test grew Yeast. The drains removed via gradually shortening on day 39 after surgery.

Epidermoid Cyst of the Mandible: Case Report (하악골에 발생한 유표피낭종: 증례보고)

  • Ohn, Byung-Hun;Koh, Se-Wook;Park, Seul-Ji;Chee, Young-Deok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.535-539
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    • 2011
  • Epidermoid cyst is a cystic form of teratoma and believed to be derived from trapped embryonic cells along the lines of embryonic closure. A 28-year-old woman presented with a painless swelling over the left mandibular area. On panoramic view, the mandible revealed a $5.5{\times}2.0\;cm^2$ multilocular radiolucent lesion of the left mandibular body and a computed tomography scan showed expansion of both the buccal and lingual plates in the same area. Microscopy found stratified squamous epithelium of the cystic wall and cystic contents of keratinized material. The histological diagnosis wasan epidermoid cyst. The most common location of epidermoid cyst at the head and neck is in the orbit (47%), followed by the mouth floor (23%) and the cervical area (9~24%), but in the jaw bone, it is considered very infrequent. We report the uncommon epidermoid cyst in the mandibular body that had a good healing outcome after treatment with a conservative marsupialization during the 40 months follow-up.

AN ELECTRON MICROSCOPIC STUDY OF THE IRRADIATION EFFECTS ON THE RAT PAROTID INTERCALATED DUCT CELLS (방사선조사가 타액선 도관세포에 미치는 영향에 관한 전자현미경적 연구)

  • Choi Won Jai;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.18 no.1
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    • pp.137-147
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    • 1988
  • This study was designed to investigate the effects of irradiation on the salivary ductal cells, especially on the intercalated ductal cells of the rat parotid glands. For this study, 36 Sprague-Dawley strain rats were irradiated on the head and neck region with absorbed dose of 15Gy by Co-60 teletherapy unit, Picker's model 4M60. The conditions irradiated were that field size, SSD, dose rate and depth were 12×5㎝m, 50㎝, 222 Gy/min. and 1㎝. respectively. The experimental animals were sacrificed 1, 2, 3, 6, 12 hours and 1, 3, 7 days after the irradiation and the changes of the irradiated intercalated duct cells of the parotid glands were examined under the light and electron microscope. The results were as follows: 1. Under the light and electron microscope, the nucleus, mitochondria and secretory granules showed severe changes in the early stage after irradiation and the most severe cellular de- generations were observed 2 hours after irradiation, but the repair processes began from 6 hours after irradiation. 2. Under the electron microscope, loss of the nuclear membranes, derrangement of the chromosomes, swelling and destruction of the secretory granules, and widening of the intercellular spaces were observed after irradiation. 3. Under the light microscope, atrophy and irregular proliferation of the ductal cells, cuboidal metaplasia, hyperchromatism, and the construction or obstruction of the lumen were observed after irradiation.

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Temporomandibular joint chondrosarcoma: a case report and literature review

  • Lee, Kyungjin;Kim, Seong Hwan;Kim, Soung-Min;Myoung, Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.5
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    • pp.288-294
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    • 2016
  • Chondrosarcoma is a malignant tumor that originates from cartilaginous cells and is characterized by cartilage formation. Only 5% to 10% of chondrosarcoma occurs in the head and neck area, and it is uncommon in the temporomandibular joint area. This report describes an unusual case with a rare, large chondrosarcoma in a 47-year-old woman who presented with painless swelling and trismus. Computed tomography showed a large mass approximately $8.5{\times}6.0$ cm in size arising adjacent to the lateral pterygoid plate and condyle. There were features suggestive of bone resorption. The tumor was resected in a single block with perilesional tissues, and a great auricular nerve graft was performed because of facial nerve sacrifice. Microscopic examination of sections stained with H&E revealed chondrocytes with irregular nuclei and heterogeneous hyper chromatic tumor cells embedded in the chondrocyte lacuna. The diagnosis was a grade I chondrosarcoma. There was no evidence of recurrence at the 8-month follow-up, and a reconstruction surgery with fibular osteocutaneous free flap was performed. We report this unusual entity and a review of the literature.

Fine Needle Aspiration Cytology of Kimura's Lymphadenitis with Characteristic Warthin-Finkeldey Type Polykaryocytes - A Case Report - (특징적인 Warthin-Finkeldey형의 다유핵 거대세포 소견을 보인 기무라 림프절염의 세침흡인 생검소견 - 1예 보고 -)

  • Kim, Yeon-Mee;Cho, Hye-Je
    • The Korean Journal of Cytopathology
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    • v.6 no.1
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    • pp.48-53
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    • 1995
  • Kimura's disease is a chronic Inflammatory disorder of unknown etiology, presenting usually as a painless subcutaneous swelling in the head and neck region or in the lymph nodes. We experienced a case of Kimura's lymphadenitis with characteristic Warthin-Finkeldey type polykaryocytes by fine needle aspiration cytology. The patient was a 10-year old male with two enlarged lymph nodes in the postauricular area. Fine needle aspiration cytology from the lymph nodes disclosed hypercellular smears with some scattered eosinophils and polykaryocytes in a polymorphous lymphoid background. There were also fragmented vessel wails and activated endothelial cell clusters in the slightly necrotic background. The Warthin-Finkeldey type polykaryocytes had three to thirty nuclei and prominent nucleoli with cytoplasmic borders. Their nuclei were arranged in grapevine or ring shaped clusters. As these polykaryocytes could also be found in lymph nodes and extranodal tissues of both reactive and neoplastic lymphoid disorders, polykaryocytes themselves are clinically nonspecific. However, the morphologic features of the Warthin-Finkeldey type giant cells are quite different from the foreign body type or Langhans' type giant cells. When the characteristic cytologic features of Kimura's disease such as significant number of eosinophils in a background of lymphoid cells asd proliferation of vessels and endothelial cells are also observed in the smear, it is possible to suggest this diagnosis in the appropriate clinical setting.

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Dogma of Extraesophaghgeal Reflux (식도 외 역류의 도그마)

  • Park, Il-Seok
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.78-83
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    • 2016
  • Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

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APPLICATION OF ARTIFICIAL DERMIS($Terudermis^{(R)}$) AND SPLIT THICKNESS SKIN GRAFT ON THE DONOR SITE OF RADIAL FOREARM FLAP (인공진피($Terudermis^{(R)}$)와 부분층 피부이식을 이용한 전완피판 공여부 수복)

  • Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.227-232
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    • 2007
  • The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.