• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권2호
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• pp.117-126
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• 2012

Epidermolysis bullosa (EB) represents a spectrum of conditions that are characterized by blistering and mechanical fragility of the skin. There is genetic heterogeneity and marked variation in clinical phenotypes in the multiple EB disorders. The most recent classification recognizes four major EB grouping and over 30 EB subtypes. The severity of EB ranges from mild to severe skin involvement, and it can be localized or generalized. Oral features include repeated occurrence of blisters, erosions, and scars, which lead to limited mouth opening, ankyloglossia, elimination of buccal vestibule, and increased risk of oral carcinoma. Routine dental care or even normal tooth brushing might cause bullae on the oral mucosa. Occasionally, the clinician will be called upon to treat patients with EB and should therefore be aware of specific treatment modifications. we present a reviews of the literature with a case providing adequate anesthetic and surgical care.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.90-92
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• 2016

Pleomorphic adenoma is the most common type of salivary gland tumor and the most common tumor of the parotid gland. Because of its propensity for invasion, pleomorphic adenoma of the parotid requires superficial parotidectomy or total parotidectomy to minimize the risk of tumor recurrence. We report a case of pleomorphic adenoma of the parotid gland with repeated recurrences. A 23-year-old male patient presented with a protruding neck mass. Six years prior to this presentation, the patient had undergone superficial parotidectomy for the removal of pleomorphic adenoma of the right parotid gland at our institution. The patient experienced recurrence at 17 months after the initial resection, which required a total parotidectomy with partial resection of the facial nerve. Pathologic examination revealed histologic findings consistent with pleomorphic adenoma across the surgical specimen from all three of the operations. The patient suffered from facial nerve paralysis, with facial expressions partially recovered over a year.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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• pp.101-103
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• 2015

In oral and maxillofacial surgery, many complications associated with nasotracheal tube can be caused. In this case, we reported ballooning tube damage of nasotracheal tube during orthognathic double-jaw surgery and replacement of tube through cut down of tube and tube exchange using airway exchange catheter. The patient scheduled for high Le Fort I osteotomy and bilateral sagittal split osteotomy was intubated nasotracheally with nasal endotracheal tube. During maxilla osteotomy, air bubble was detected in the oral blood. In spite of our repeated ballooning, the results were the same so we changed damaged tube using airway exchange catheter aseptically. Tiny and superficial cutting site was detected in the middle of pilot tube. As we know in our case, tiny injury impeded a normal airway management and prevention is important.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.593-598
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• 2005

Although several suspension biomaterials have been considered to be relatively safe and convenient, varying degrees of resorption have required repeated percutaneous injection. In the previous animal study the authors have reported that cultured human fibroblasts suspended in $Restylane^{(R)}$, which is modified hyaluronic acid, could produce human dermal matrices and prolong the effect of this gel. This study was undertaken to evaluate the clinical efficacy of this method. A total of 11 patients ranging from 25 to 57 years of age were included in this study between January of 2002 and December of 2003. All the patients were treated for the purpose of augmentation rhinoplasty. $1{\times}10^7/ml$ or $1.5{\times}10^7/ml$ cultured fibroblasts were suspended in 0.7 to 1.4 ml of $Restylane^{(R)}$. The implants were transferred to a 1-ml syringe and injected subcutaneously to the nose of the patients. Among 11 patients, long term follow-up for more than 1 year was possible in 6 patients. The injected implants remained in site without evidence of resorption or loss of correction. All the patients were satisfied with long term results of this method. There was no complication during the follow-up period.

• Journal of Chest Surgery
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• 제19권1호
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• pp.25-34
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• 1986

Recently, radionuclide angiocardiogram is one of the most common procedure for assessment of ventricular performance due to its distinctive advantages such as safety, accuracy, and ease of repeated studies. Also, measurement and comparison between pre and postoperative left ventricular ejection fraction [LVEF] are meaningful for assessing the severity of myocardial damage which occurred during open heart surgery and the status of myocardial recovery. We obtained pre and post operative LVEF using radionuclide angiocardiogram on 30 patients composed of atrial septal defect, ventricular septal defect, cyanotic congenital heart disease, and valvular heart disease who undergone the open heart surgery from March to august 1984. The study revealed that ventricular septal defect and mitral valvular heart disease showed 8.1% and 6.2% decreases of postoperative LVEF, respectively. But, there are little increases of postoperative LVEF in the atrial septal defect and cyanotic congenital heart disease. In ventricular septal defect, each group of Qp/Qs over 2.0 and systolic pulmonary artery pressure over 50mmHg showed significant 17% and 14.7% decreases of postoperative LVEF, respectively. Considering the duration of the aortic cross clamping times and closing methods of VSD, each group of duration over 30 min. and of patch closure showed 13.9% and 14.2% decreases of LVEF between pre and postoperative status respectively which was significant finding statistically.

• Journal of Gastric Cancer
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• 제18권3호
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• pp.305-312
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• 2018

We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and docetaxel chemotherapy for 6 months after surgical resection of the abdominal wall metastasis. At the last visit, 7.8 years since the initial resection of the primary gastric cancer and 6.2 years since detection of the first metastases, the patient was disease-free and required no further chemotherapy. This case suggests that repeated local therapy offers potential for long-term survival in a carefully selected subset of patients with recurrent metastases.

• 대한족부족관절학회지
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• 제8권1호
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• pp.26-30
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• 2004

감염된 당뇨병성 족부궤양의 병실내 벽매립형 중앙 흡인 장치를 이용한 창상 밀봉관리로 빠른 창상의 호전을 얻을 수 있었다. 이 창상관리 방법은 빠른 창상의 호전 외에도 비용을 획기적으로 줄일 수 있으며 환자의 동통을 줄이고 병실내 세균 전파의 위험이 적으며 필요 인력 축소 등의 장점이 있으나 말기신장부전 환자에서의 적용은 추가의 연구가 필요할 것으로 사료된다.

• 한국산학기술학회논문지
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• 제16권2호
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• pp.1189-1199
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• 2015

본 연구의 목적은 산부인과 전신마취 수술환자의 불안과 활력징후에 선호음악이 미치는 효과를 검증하는 것이다. 연구 설계는 비동등성 대조군 전후 시차설계이다. 연구기간은 2013년 5월 1일부터 7월 30일까지이며, 대상자는 W대학병원의 산부인과 수술환자로 실험군 21명, 대조군 23명, 총 44명이다. SPSS Win 18.0을 활용하여 Repeated measures ANOVA로 자료를 분석하였다. 연구 결과 선호음악을 제공받은 실험군과 제공받지 않은 대조군 간의 불안은 수술실 입실 시와 마취직전 사이 및 마취 직전과 의식 회복 후(p=.003; p=.011)의 시점에서 유의한 차이를 보였다. 수축기 혈압은 의식 회복 후와 회복실 퇴실 시 사이에 유의한 차이를 보였으며(p=.023), 맥박은 마취 직전과 의식 회복 후 사이에서 유의한 차이가 있었다(p=.016). 향후 선호음악 요법은 산부인과 전신마취 수술환자의 불안 감소 및 안정된 활력징후를 유지를 위한 효과적인 간호중재로 적용될 수 있다.

• Journal of Korean Neurosurgical Society
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• 제41권6호
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• pp.391-396
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• 2007

Objective : This study was performed to review the clinical characteristics and operative results of brain abscess in order to define the therapeutic strategy for this disease. Methods : We reviewed the medical records and radiology images of brain abscess patients treated in our hospital during the last 16 years. A total of 35 cases included 23 males and 12 females, with the mean age of 48 years old. We excluded cases of postoperative, post traumatic, and fungal abscess. All patient underwent at least one surgical treatment such as stereotactic aspiration or craniotomy with excision. Results : Twenty seven [77.1%] patients presented with symptoms of increased intracranial pressure. The frontal lobe was the most common anatomical place, and streptococcal species were the most frequently encountered pathogens. The chronic pulmonary diseases and chronic otitis media are common underlying condition. Eighteen patients underwent stereotactic aspiration and 17 patients had excision of their abscess as an initial treatment. Seven patients had a repeated surgery, 6 of them had been treated with aspiration initially. At discharge, 60.0% patients showed a favorable outcome. Conclusion : The stereotactic drainage would be more suitable for the brain abscess located in deep and eloquent area. A large, solitary, and well-encapsulated lesion of superficial location could be best treated with complete excision, and this procedure was more definite because it is associated with less repeated surgery and showed more favorable outcome compared to aspiration surgery.

• Journal of Chest Surgery
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• 제57권2호
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• pp.152-159
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• 2024

Background: Anastomotic leakage (AL) following esophagectomy represents a serious complication that often results in prolonged hospitalization and necessitates repeated interventions, including nothing-by-mouth (NPO) restriction, endoscopic vacuum therapy (EVT), or surgical repair. In this study, we evaluated the patterns and outcomes of AL treatment. Methods: We retrospectively reviewed the medical records of patients who underwent esophagectomy for esophageal cancer at a single center between 2003 and 2020. Of 3,096 examined cases, 181 patients (5.8%) with AL were included in the study: 114 patients (63%) with cervical anastomosis (CA) and 67 (37%) with intrathoracic anastomosis (TA). Results: The incidence of AL was 11.9% in the CA and 3.2% in the TA group (p<0.001). Among patients with CA who developed AL, 87 (76.3%) were managed with NPO, 15 (13.2%) with EVT, and 12 (10.5%) with surgical repair. Over 90% of patients with cervical AL resumed an oral diet by the time of discharge, regardless of treatment method. Among patients with TA and AL, 36 (53.7%) received NPO, 25 (37.7%) underwent EVT, and 6 (9%) required surgery. Of these, 34 patients who were managed with NPO and 19 with EVT could resume an oral diet. However, only 2 patients who underwent surgery resumed an oral diet, and 2 patients required additional EVT. Conclusion: Although patients with CA displayed a higher incidence of AL, their rate of successful oral intake exceeded that of those with TA, regardless of treatment method. Among patients exhibiting AL with TA, EVT was more commonly employed than in CA cases, and it appears effective.