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Brachial Plexus Injury after Wedge Resection by Axillary Thoractomy (액와 개흉술에 의한 기흉수술시 발생한 상완신경총 손상)

  • 김동원
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.328-330
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    • 1994
  • Brachial plexus injury developing after axillary thoracotomy is an uncommon complication. But if it occurs, it may cause annoying events. We recently experienced 2 patients who developed brachial plexus injury after wedge resection by axillary thoracotomy . The first patient was a 22 year-old man with right spontaneous pneumothorax . After wedge resection of the right upper lung by axillary thoracotomy, he complained total paralysis of the right arm. An electromyogram was obtained at 7 days after operation, with the confirmation of brachial plexus injury. He was discharged at 22days after operation and brachial plexus injury was completely recovered 4 months after discharge. The second patient was a 17 year-old man with recurrent right pneumothorax. He underwent wedge resection of the right upper lung by axillary thoracotomy. Electromyogram confirmed the diagnosis of brachial plexus injury in the immediate postoperative period. He was discharged at 15 days after operation and brachial plexus injury was recovered 2months after discharge.Brachial plexus injury after axillary thoracotomy is caused by stretching around the clavicle and tendon of pectoralis minor by fixation of the abducted arm to the frame. Thus, when we perform wedge resection by axillary thoracotomy, we must avoid over-stretching of the brachial plexus in positioning. If brachial plexus injury develops, immediate attention and management with close rapport are important to avoid possible medicolegal problems.

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Retromandibular approach for the management of subcondylar fractures, followed by treatment of parotid gland fistulae: Case report (하악 과두하 골절시 후하악 접근법에 의한 수술 후 발생한 이하선 누공 형성과 이에 대한 치료 증례)

  • Ro, Jae-Chan;Kim, Ju-Won;Yang, Byoung-Eun
    • The Journal of the Korean dental association
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    • v.55 no.10
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    • pp.696-705
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    • 2017
  • Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

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Hereditary protein S deficiency presenting acute pulmonary embolism

  • Kim, Jiwan;Kim, Sung Hea;Jung, Sang Man;Park, Sooyoun;Yu, HyungMin;An, Sanghee;Kang, Seonghui;Kim, Hyun-Joong
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.52-55
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    • 2014
  • Protein S deficiency is one of the several risk factors for thrombophilia and can cause blood clotting disorders such as deep vein thrombosis and pulmonary embolism. A 54-year-old man was admitted with the complaint of dyspnea and was diagnosed with pulmonary embolism. The patient had very low level of free protein S, total protein S antigen, and protein S activity (type I protein S deficiency). In history taking, we found that his mother, 78 year old, had a history of same disease 10 years ago, and confirmed the pronounced low level of protein S. The patient's son also had very low level of protein S, however there had not been any history of pulmonary embolism yet. This case study suggests that asymptomatic persons with a family history of protein S deficiency and pulmonary embolism should be checked regularly for early detection of the disease, as protein S deficiency can be suspected.

Deep Sylvian Meningioma in a 43-Year-Old Man: A Case Report (43세 남자에게서 발생한 심부실비우스열뇌수막종: 증례보고)

  • Kim, Jin Young;Lee, Eun Joo;Chang, Hyuk Won;Jung, Hye-Ra;Kim, Eal Maan;Kim, Sang Pyo
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.4
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    • pp.308-311
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    • 2013
  • Deep sylvian meningioma is a rare form of meningiomas. So far, only 4 cases including the present one have been reported in South Korea. A 43-year-old man without any previous medical history presented to our hospital with seizure. There was a rim enhancing mass in the right deep sylvian fissure without dural attachment on magnetic resonance images. Surgical resection of the mass revealed the lesion to be a meningioma in this patient.

Basal Cell Adenoma of the Parotid Gland (이하선에 발생한 기저세포선종)

  • Choi Il-Sup;Park Cheong-Soo;Kim Choon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.91-96
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    • 1987
  • The basal cell adenoma of the parotid gland is rare benign disease, first described and adequately documented as a distinctive tumor from benigh mixed tumors(pleomorphic adenoma) by Kleinsasser and Klein in 1967. This tumors is an isomorphic epithelial tumor of salivery gland, characteristic of absence of myoepithelial cells which are present in pleomorphic adenoma and other salivery gland tumors. Clinicopathologically the tumors is very difficult to differentiate with pleomorphic adenoma or adenoid cystic carcinoma. The prognosis is excellent by complete extirpation of the tumor. The present report presents two cases of basal cell adenoma of the parotid gland seen in 63 year old man and 71 year old man in one-year period at Department of Surgery, Yonsei University, College of Medicine.

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Two Cases of Psoriasis treated with Sasang Constitutional Therapy and Fasting Therapy (사상처방과 단식요법을 활용한 건선(乾癬) 치험 2례)

  • Han, Su-Jin;Song, Jeong-Mo
    • Journal of Sasang Constitutional Medicine
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    • v.22 no.4
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    • pp.130-139
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    • 2010
  • 1. Objectives The purpose of this study was to give an account of the effects of Sasang constitutional medicine and fasting therapy for the patient who has suffered from various signs or symptoms caused by psoriasis. 2. Methods The cases were one 50-year old man diagnosed as Taeeumin and one 29-year old man diagnosed as Soyangin. They all have the symptoms caused by psoriasis, such as rash, erythema, scaly skin, itching, etc. So we've recorded the progress of their symptoms as a score at the tables to check their conditions throughout the hospitalized period. We've diagnosed them as Soyangin, Taeeumin have prescribed Yangdokbaecho-tang and Galgeunhaegi-tang and have carried out fasting therapy. 3. Results and Conclusions The general condition of the patient have improved incredibly, where the each scores at the tables dropped from 4 to 0,1 and their symptoms like rash, erythema, scaly skin, itching, edema have almost disappeared at the end of the hospitalization period. This indicates that Yangdokbaecho-tang and Galgeunhaegi-tang can be used to treat main symptoms of psoriasis and fasting therapy can be used as a subsidiary therapy for the psoriasis.

Two Cases of Fatal Paraquat Intoxication by Parenteral Injection (비경구적 투여에 의한 치명적인 파라캇 중독증 2례)

  • Kim, Dong-Hoon;Lee, Kyung-Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.5 no.2
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    • pp.119-122
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    • 2007
  • Paraquat poisoning is a fatal type of herbicide intoxication. It is characterized by multi-organ failure and pulmonary fibrosis with respiratory failure. Intravenous and intramuscular injection of paraquat is rarely described. However, We encountered two fatal cases of acute poisoning caused by paraquat injection. Two patients were admitted to our emergency unit after intravenous and intramuscular injection of 23.8% paraquat (about 476 mg of paraquat). A 37-year-old man diluted 2 ml of 23.8% paraquat solution with 1 ml of normal saline and injected it both intravenously into his left antecubital fossa and intramuscularly into his abdomen in a suicide attempt. He died 5 days later from respiratory failure and acute renal failure. A 92-year-old man was injected intravenously into his right antecubital fossa by his grandson with 2 ml of 23.8% paraquat solution diluted with 1 ml of normal saline. He died 2 days later from early circulatory collapse and multi-organ failure (metabolic acidosis, acute renal failure, coagulopathy). Intravenous and intramuscular injection with a small quantity of paraquat resulted in fatal toxicity in our patients.

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A 45-Year-Old Man With Recurrent Dyspnea and Hemoptysis during Exercise: Exercise-Induced Pulmonary Hemorrhage/Edema

  • Kim, Dae Sung;Lee, Minhyeok;Kwon, Oh Jung;Jeong, Inbeom;Son, Ji Woong;Na, Moon Jun;Kwon, Sun Jung
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.375-379
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    • 2015
  • A 45-year-old man presented with dyspnea and hemoptysis during exercise. A chest computed tomography (CT) revealed multifocal diffuse patchy ground glass opacity and interlobular septal thickening in both the lungs. Permeability pulmonary edema or pulmonary hemorrhage was suspected. Serologic studies for autoimmune disorders and vasculitis were negative. There was no laboratory evidence of coagulopathy, other hematopoietic disease or infectious disease. Considering correlation with exercise, we diagnosed exercise-induced pulmonary hemorrhage (EIPH) or exercise-induced pulmonary edema (EIPE). The patient was managed with antifibrinolytics, antibiotics, and antitussive agent. After a week, follow-up chest CT revealed completely resolved pulmonary hemorrhage. About 2 months after the first event, he visited again with dyspnea and hemoptysis during running. In the present study, we report a case of recurrent pulmonary hemorrhage after exercise.

Unusual malignant neoplasms occurring around dental implants: A report of 2 cases

  • Oh, Song Hee;Kang, Ju Hee;Seo, Yu-Kyeong;Lee, Sae Rom;Choi, Yong-Suk;Hwang, Eui-Hwan
    • Imaging Science in Dentistry
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    • v.48 no.1
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    • pp.59-65
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    • 2018
  • Osseointegrated implants are now commonplace in contemporary dentistry. However, a number of complications can occur around dental implants, including peri-implantitis, maxillary sinusitis, osteomyelitis, and neoplasms. There have been several reports of a malignant neoplasm occurring adjacent to a dental implant. In this report, we describe 2 such cases. One case was that of a 75-year-old man with no previous history of malignant disease who developed a solitary plasmacytoma around a dental implant in the left posterior mandible, and the other was that of a 43-year-old man who was diagnosed with squamous cell carcinoma adjacent to a dental implant in the right posterior mandible. Our experiences with these 2 cases suggest the possibility of a relationship between implant treatment and an inflammatory cofactor that might increase the risk of development of a malignant neoplasm.

Clinical Application of Fat Tissue Wraparound Splint after Facial Nerve Repair (안면신경 봉합 후 지방조직으로 둘러싼 부목의 임상적 적용)

  • Lee, Yong Jig;Ha, Won Ho
    • Archives of Craniofacial Surgery
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    • v.14 no.1
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    • pp.46-49
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    • 2013
  • Facial deformity after nerve injury changes ones' social life. We experienced a few patients with healthy early recovery of muscle contraction after the operation with soft tissue wraparound splint. Under general anesthesia, exploration to find as many injured nerve stumps with ${\times}2.5$ loopes was undertaken at first. Interfascicular repair was done with minimal tension by 10-0 nylon under a microscope, and the suture site was sealed by approximating the surrounding fat flaps. This conjoined adipose tissue flap was a splint as a wraparound environment to reduce the tension in the coaptation site, and to increase the relative concentration of releasing neurotrophic factors by surrounding it. A 45-year-old man fell down in a drunken state and had deep laceration by broken flowerpot fragments with facial muscle weakness on the right cheek. His injured mandibular branches of the facial nerve were found. A 31-year-old female suffered from motionlessnesss of frontalis muscle after a traffic accident. She had four frontal branches injured. The man had his cheek with motion after seven days, and the woman two months after the operation. The nerve conduction test of the woman showed normalized values. Facial nerve repair surrounded by adipose tissue wraparound splint can make the recovery time relatively short.