• Title/Summary/Keyword: Skin infection

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Chest Wall Implantation of Lung Cancer after Fine Needle Aspiration Biopsy - 2 cases - (세침 흡입생검 후 발생한 폐암의 흉벽전이 -2례 보고-)

  • 강정신;조현민;윤용한;이두연
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.629-633
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    • 1998
  • Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

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Predictive Value of Sensory Nerve Conduction in Carpal Tunnel Syndrome

  • Park, Sa-Kyuk;Lee, Jung-Ho;Lee, Hyuk-Gee;Ryu, Kee-Young;Kang, Dong-Gee;Kim, Sang-Chul
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.401-405
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    • 2006
  • Objective : Electrodiagnostic test has shown diagnostic sensitivity and specificity in carpal tunnel syndrome[CTS]. This study was to evaluate the correlation between clinical outcome of endoscopic carpal tunnel ligament release[ECTR] and the predictive value of sensory nerve conduction. Methods : From January 1998 to December 2004, 87 patients [44 right hand, 37 left hand, 6 bilateral hands] with CTS who underwent ECTR were followed up in our hospital for an average of 24 months. We retrospectively analyzed the results with previous medical records. All patients underwent electrodiagnostic test and ECTR. The patients were divided into three groups according to the electrodiagnostic test results. Group [A] was normal sensory nerve response, Group [B] was slowing sensory response and Group [C] was no sensory response. Improvement of the symptom after ECTR was assessed using a visual analogue scale[VAS] score. Results : Differences between the three groups on the correlation of severity of sensory potential and duration of preoperative symptoms were significant. The mean value of improved VAS scores for the three groups were $6.0{\pm}0.96$ in the Group A, $6.11{\pm}0.48$ in the Group B and $6.14{\pm}0.53$ in the Group C. There was no statistically significant difference between the severity of sensory nerve response and improvement in VAS score after ECTR. Complications included a wound infection, a case of skin necrosis, and two patients with persistent symptoms without any improvement. Conclusion : Although electrodiagnostic test has been known to be useful, sensory nerve response is considered not to be a good prognostic value for carpal tunnel syndrome after ECTR.

A Groove Technique for Securing an Electrode Connector on the Cranial Bone : Case Analysis of Efficacy

  • Lee, Sung-Woo;Lee, Myung-Ki;Seo, Il;Kim, Ho-Sang;Kim, Jeong-Ho;Kim, Yun-Suk
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.130-134
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    • 2014
  • Objective : A groove technique for securing an electrode connector was described as an alternative surgical technique in deep brain stimulation (DBS) surgery to avoid electrode connector-related complications, such as skin erosion, infection, and migration. Methods : We retrospectively reviewed 109 patients undergoing one of two techniques; the standard technique (52 patients using 104 electrodes) and the groove technique (57 patients using 109 electrodes) for securing the electrode connector in DBS surgery, regardless of patient disease. In the standard percutaneous tunneling technique, the connector was placed on the vertex of the cranial surface. The other technique, so called the groove technique, created a groove (about 4 cm long, 8 mm wide) in the cranial bone at the posterior parietal area. Wound erosion and migration related to the connectors were compared between the two techniques. Results : The mean follow-up period was 73 months for the standard method and 46 months for the groove technique. Connector-related complications were observed in three patients with the groove technique and in seven patients with the standard technique. Wound erosion at the connector sites per electrode was one (0.9%) with the groove technique and six (5.8%) with the standard technique. This difference was statistically significant. The electrode connector was migrated in two patients with the groove technique and in one patient with the standard technique. Conclusions : The groove technique, which involves securing an electrode using a groove in the cranial bone at the posterior parietal area, offers an effective and safe method to avoid electrode connector-related complications during DBS surgery.

A Study on Application of Radix Asari Main Blended Prescription From Dongeubogam (동의보감(東醫寶鑑) 중(中) 세신(細辛)이 주약(主藥)으로 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察))

  • Jeon Ho-Cheol;Rho Euy-Joon;Kim Hyung-Rul;Yun Young-Gab
    • Herbal Formula Science
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    • v.12 no.2
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    • pp.57-76
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    • 2004
  • This report describes the remedial fields, symptoms, pathology, dosage, prescriptional constitution of 69 studies related to the use of Radix Asari main blended prescriptions from Dongeubogam. The following conclusions were reached through investigations on the prescriptions that use Radix Asari as a key ingredient. Radix Asari blended prescriptions are utilized for 14 therapeutic purposes, for example, in symptoms of tooth, eye, paralysis, ear-nose, skin infection and carbuncle. In particular, 14.49% of the prescriptions appear in the chapter of tooth, and 10.14% of those appear in the chapter of eye. Prescriptions that utilize Radix Asari as the main ingredient are used in the treatment of dental disease, othalmology, nose and ear disease, throat disease, common cold, dermothology, paralysis, musculoskeletal disease, disease of the head, asthma, genital disease, the injury of the cuts and they are also used for treating 50 different types of diseases. Radix Asari is used in Six pathogenic factors such as wind, wind-cold, wind-heat, wind-dampness heat, wind-dampness, dampness, paralysis, cold-chill, cold, dryness, in visceral pathogenic factors such as stomach, kidney, liver-kidney, liver and in chi-blood pathogenic factors such as chi-blood deficiency, chi-blood stagnation and in extravasated blood pathogenic factors such as impact injury, an injury such as cuts, blood accumulation as well as weakness-cold and parasites. The actual amount of Radix Asari blended has ranged at a wide variety of amounts from 2.5pun(about 0.94gram) to 3don(about 11.25gram). 26.09% of the prescriptions used 1don(about 3.75gram). The function of Radix Asari is to calm down, to get the consciousness back, to bore through, to warm up the meridians and to run it smoothly, to discharge of phlegm from the combination of drugs and prescriptions.

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Use of the Fix and Flap Approach to Complex Open Elbow Injury: The Role of the Free Anterolateral Thigh Flap

  • Chui, Christopher Hoe-Kong;Wong, Chin-Ho;Chew, Winston Y.;Low, Mun-Hon;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.130-136
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    • 2012
  • Background : Complex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner. Methods : A retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed. Five patients were identified and included in this study. Results : We present a series of 5 cases managed with this principle. Soft tissue defects ranged in size from $4{\times}9cm$ ($36cm^2$) to $15{\times}30cm$ ($450cm^2$) and were located either posteriorly (n=4) or anteriorly (n=1). Associated injuries included open fractures (n=3) and motor nerve transection (n=2). Wound coverage was achieved in a mean duration of 18.8 days (range, 11 to 42 day). There were no flap failures and no major complications. The mean postoperative active elbow motion was $102^{\circ}$ (range, $45^{\circ}$ to $140^{\circ}$). Conclusions : In our small series we have highlighted the safety and utility of using the free ALT flap in complex elbow injuries. The ALT flap has many advantages which include abundant skin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our series to obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and, access to fascia lata grafts for reconstruction of the triceps tendon.

A Rare and Often Unrecognized Brain Meningitis and Hepatopneumonic Congestion are a Major Cause of Sudden Death in Somatic Cloned Piglets

  • 박미령;조성근;임여정;박종주;김진회
    • Proceedings of the KSAR Conference
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    • 2003.06a
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    • pp.18-18
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    • 2003
  • In human, sudden infant death syndrome(SIDS) is synonyms for the sudden, unexpected and unexplained death of an infant. The incidence of SIDS has been estimated to be from 1 to 3%. Cloning has a relatively high rate of late abortion and early postnatal death, particularly when somatic cells are used as donors of nuclei and rates as high as 40 to 70% have been reported. However, the mechanisms for SIDS in cloned animals are not known yet. To date, few reports provide detailed information regarding phenotypic abnormality of cloned pigs. In this study, most of the cloned piglets were alive at term and readily recovered respiration. However, approximately 82% of male cloned piglets (81/22) died within a week after birth. Significant findings from histological examinations showed that 42% of somatic cloned male piglets died earlier than somatic cloned female piglets, most probably due to severe congestion of lung and liver or neutrophilic inflammation in brain, which indicates that unexpected phenotypes can appear as a result of somatic cell cloning. No anatomical defects in cloned female piglets were detected, but three of the piglets had died by diarrhea due to bacterial infection within 15 days after birth. Although most of male cloned piglets can be born normal in terms of gross anatomy, they develop phenotypic anomalies that include leydig cell hypoplasia and growth retardation post-delivery under adverse fetal environment and depigmentation of hair- and skin-color form puberty onset. This may provide a mechanism for development of multiple organ system failure in some cloned piglets. Th birth weights of male cloned pig in comparison with those of female cloned piglets are significantly reduced(0.8 vs 1.4kg) and showed longer gestational day(120 vs 114). In conclusion, brain meningitis and hepatopneumonic congestion are a major risk factor for SIDS and such pregnancy in cloned animals requires close and intensive antenatal monitoring.

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Ultrasound-guided internal jugular vein catheterization in critically ill pediatric patients

  • Yang, Eu Jeen;Ha, Hyeong Seok;Kong, Young Hwa;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.58 no.4
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    • pp.136-141
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    • 2015
  • Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, $6.54{\pm}1.06$ years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was $1.57{\pm}0.34$ and $14.07{\pm}1.91$ minutes, respectively, the mean catheter dwell time was $14.73{\pm}2.5$ days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

A Novel Implantable Cerebrospinal Fluid Reservoir : A Pilot Study

  • Byun, Yoon Hwan;Gwak, Ho Shin;Kwon, Ji-Woong;Kim, Kwang Gi;Shin, Sang Hoon;Lee, Seung Hoon;Yoo, Heon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.640-644
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    • 2018
  • Objective : The purpose of this pilot study was to examine the safety and function of the newly developed cerebrospinal fluid (CSF) reservoir called the V-Port. Methods : The newly developed V-Port consists of a non-collapsible reservoir outlined with a titanium cage and a connector for the ventricular catheter to be assembled. It is designed to be better palpated and more durable to multiple punctures than the Ommaya reservoir. A total of nine patients diagnosed with leptomeningeal carcinomatosis were selected for V-Port insertion. Each patient was followed up for evaluation for a month after the operation. Results : The average operation time for V-Port insertion was 42 minutes and the average incision size was 6.6 cm. The surgical technique of V-Port insertion was found to be intuitive by all neurosurgeons who participated in the pilot study. There was no obstruction or leakage of the V-Port during intrathecal chemotherapy or CSF drainage. Also, there were no complications including post-operative intracerebral hemorrhage, infection and skin problems related to the V-Port. Conclusion : V-Port is a safe and an easy to use implantable CSF reservoir that addresses problems of other implantable CSF reservoirs. Further multicenter clinical trial is needed to prove the safety and the function of the V-Port.

A CLINICAL STUDY ON SOFT TISSUE INJURIES OF ORAL & MAXILLOFACIAL REGION (구강 및 악안면 영역의 연조직 손상에 관한 임상적 연구)

  • You, Jun-Young;Kim, Yong-Kwan;Bae, June-soo;Chang, Hyun-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.407-413
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    • 1997
  • The soft tissue injuries of Oral & Maxillofacial region include abrasion, contusion, simple laceration, laceration of skin with underlying tissue, soft tissue injuries combined with facial bone fracture and involving functional structures such as facial nerve and vessel, orbit, lacrimal duct and salivary gland and so on. The results obtained were as follows ; 1. The age range was 1 to 97, and the highest incidence occured in the 3rd decade(23.4%), followed by the 1st decade(20.2%), 4th decade(18.1%), 4th decade(18.1), and 5th decade(14.3%) 2. The sexual ration was 4 : 1(M : F). 3. The most common cause of facial laceration was a accident(54.5), followed by blow(17.8%), traffic accident(15.9%) and unknown(10.8%). 4. The most frequently occurred site of injury was a forehead(24), followed by oral cavity(16.9%), lip(15%), eyebrow(14.5%), cheek(14%), chin(11.8%), nose(2%), scalp(1.4%) and neck(0.9%). 5. Most of wound size was less than 3cm in length. 6. 28 patients suffered facial bone fracture, representing 7%. 7. The major complications following facial laceration were infection and facial paralysis caused by facial nerve injuries, representing 4.5% and 1.9%.

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Arthroscopic Resection of Prepatellar Bursitis (슬개골전 점액낭염의 관절경적 절제술)

  • Chae In-Jung;Han Seung-Beom;Lee Byung-Taek
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.38-41
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    • 2000
  • Purpose : We report a result of arthroscopic resection after inner-wall staining for treatment of prepatellar bursitis which was not treated conservatively. Materials and Methods : Between January 1996 and October 1998, We treated arthroscopically 11 patients with prepatellar bursitis. Arthroscopic resection was performed with shaver after inner-wall staining using Methylene Blue and then placed continuous suction drainage and compressive dressing. Results : All patients had no tender scars and were able to walk immediately after procedure. We found one case of late infection during follow-up. Conclusion : Arthroscopic bursectomy minimizes the complication of open bursectomy such as pain or large scar. Skin perforation would be prevented by inner-wall staining.

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