• Journal of Chest Surgery
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• 제26권11호
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• pp.845-850
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• 1993

Post-Pneumonectomy Empyema[PPE] is a relatively uncommon but serious complication. And the management of it remains a disturbing and controversial area in the field of general thoracic surgery. Many methods have described and have had varying degrees of success. For the purpose of providing the guideline for management of post-pneumonectomy empyema, we reviewed our experiences of treatment of PPE from January 1985. to December 1992. There were 17 cases, which consist 7.9% of all pneumonectomy cases for that period. There were 13 male and 4 female patients with mean age of 47.1$\pm$ 16.2 yrs old. Both chest has the same incidence. The most common disease for prior pneumonectomy was tuberculosis, but the PPE was the most frequently occurred in empyema. The duration between pneumonectomy and PPE was 44.7 $\pm$81.1 months, where 58.8% of patients occurred within 1 month. Fever was the most frequent complaint and wound dischrge was detected in less than half of patients. There were 2 in-hospital mortalities.Mostly, in 13 cases, we did Eloesser operation. Five of them could finish second Clagett procedure, but one had recurrence. Four bronchopleural fistular patients underwent 3 single stage muscle flap closure and 1 direct closure with modified Clagett procedure. None had recurrence. Mean follow-up duration is 30.9\ulcorner22.3 months. There was 1 late death which was not related to PPE but to Malignancy recurrence.

• 대한두경부종양학회지
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• 제30권2호
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• pp.115-118
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• 2014

Papillary thyroid carcinoma is known as its relatively high cure rate after surgical treatment. But invasion of the trachea by thyroid carcinoma is poor prognostic factor and the best management is en bloc surgical resection of the tumor invading the trachea. A 55-year-old man was diagnosed as papillary thyroid cancer with tracheal invasion. We treated the patient by total thyroidectomy with window resection of invading trachea followed by immediate reconstruction with sternohyoid muscle flap and tracheostomy. At 48 days after surgery, tracheostoma was closed and the patient had no functional complication by the surgical process. Until 10 months after surgery, there was no sign of recurrence and the patient led social life without any discomfort. We present this case with a review of the related literatures.

• 대한두개안면성형외과학회지
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• 제12권1호
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• pp.37-42
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• 2011

Purpose: Cancer arising from the external auditory canal is a rare disease. A lesion that seems harmless in someway, can be lethal when inadequately excised, the tumor may infiltrate nerves, the parotid and auditory tissues before re-invading the skin. Wide resection of the lesion surrounding the structure and reconstruction with an adequate plan is crucial for the treatment of this disease. Methods: Two patients with external auditory canal cancer were treated with muscle flaps and skin grafts. Lateral temporal bone resection (LTBR) was performed for complete resection of the cancer. The defect cavity was obliterated with highly vascularized tissue using pedicled sternocleidomastoid muscle, and temporalis muscle individually, combined with full thickness skin graft for covering the skin defect of the ear. Results: Clear resection margin was obtained, and both patients showed disease free survival during the follow up. There was no complications of hematoma, infection, flap loss, or wound problem in both patients. Both patient received radiation therapy, there was no osteoradionecrosis or any other complication related to radiation therapy. Conclusion: Utilizing pedicled muscle flaps for managing defects after wide resection of the external auditory canal cancer is an effective method for managing this difficult disease.

• 대한두개안면성형외과학회지
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• 제14권1호
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• pp.65-68
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• 2013

Muir-Torre syndrome is defined by concurrent or sequential development of internal malignancy and sebaceous neoplasm or multiple keratoacanthomas. Muir-Torre syndrome is very rare, with only 205 cases reported in the literature. We reported a patient with Muir-Torre syndrome with three internal malignancies. A 64-year-old patient with a history of breast cancer, stomach cancer and colon cancer visited our department for treatment of the skin lesion that occurred five years before on the left cheek. The lesion was excised completely with a resection margin of 1 cm, followed by full-thickness skin graft from left postauricular area for reconstruction. Histopathology revealed a $0.2{\times}0.2{\times}0.1cm$ sized sebaceous carcinoma with 4 mm safety margin. The skin graft was well taken within 7 days after surgery and the patient was discharged to outpatient follow-up. There was no complication related with surgery. Muir-Torre syndrome is very rare, as are sebaceous gland tumors. So if a cancer of the sebaceous gland is diagnosed, screening workup for internal malignancy is recommended. Because of its good prognosis, surgical removal of primary or metastatic cancers may be curative and should be attempted where possible.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.291-302
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• 2019

Median sternotomy is the most popular approach in cardiac surgery. Post-sternotomy wound complications are rare, but the occurrence of a deep sternal wound infection (DSWI) is a catastrophic event associated with higher morbidity and mortality, longer hospital stays, and increased costs. A literature review was performed by searching PubMed from January 1996 to August 2017 according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following keywords were used in various combinations: DSWI, post-sternotomy complication, and sternal reconstruction. Thirty-nine papers were included in our qualitative analysis, in which each aspect of the DSWI-related care process was analyzed and compared to the actual standard of care. Plastic surgeons are often involved too late in such clinical scenarios, when previous empirical treatments have failed and a definitive reconstruction is needed. The aim of this comprehensive review was to create an up-to-date operative flowchart to prevent and properly treat sternal wound infection complications after median sternotomy.

• Restorative Dentistry and Endodontics
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• 제44권3호
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• pp.32.1-32.13
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• 2019

Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.

• Journal of Medicine and Life Science
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• 제16권2호
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• pp.46-51
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• 2019

Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

• 대한영상의학회지
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• 제84권4호
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• pp.934-940
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• 2023

뇌실-복강 단락술은 가장 널리 사용되고 있는 수두증의 수술적 치료 방법이다. 단락술과 관련된 합병증은 비교적 흔하게 발생하며, 높은 단락장치 교정술 시행률과 관련이 있다. 그러나 원위도관이 다른 장기 내로 전위되는 경우, 특히 심장 및 혈관 내 전위는 드물게 보고되었다. 드물지만 잠재적으로 위험한 합병증에 대해 알고 있는 것은 신속한 처치를 통해 위중한 상황을 예방할 수 있기 때문에 중요하다. 저자들은 뇌실-복강 단락술 시행 2개월 후 원위도관이 좌측 내경정맥을 통해 심장 및 양측 폐동맥 내로 전위되었던 23세 남자 환자의 증례를 보고하고, 발생 가능한 기전과 치료에 관해 논의해 보고자 한다.

• Advances in pediatric surgery
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• 제19권2호
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• pp.81-89
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• 2013

The purposes of this study was to describe the clinical correlation of mass size and gestational age, prognostic factors in sacrococcygeal teratoma (SCT) at a tertiary pediatric surgery, University of Ulsan College of Medicine and Asan Medical Center (AMC), Seoul, Korea. Fifty five patients admitted to the AMC with a SCT between May 1989 and April 2013 were included in this retrospective review. Mean follow up was 861 days. Mean maternal age at delivery was $30{\pm}2.7$ year, mean gestational age (GA) was $36.9{\pm}3.6$ wks, and preterm delivery was 21.8%. Birth body weight was $3182{\pm}644$ g and male vs. female ratio was 1:2.05. We can't find significant difference between Caesarean section and maternal age at delivery (p =0.817). But, caesarean section was favored by gestational age (p = 0.002), larger tumor size (p =0.029) or higher tumor weight fraction rate to birth body weight (p =0.024). Type I was 13, II 21, III 17, and IV 3 according to Altman et al. classification. The tumor component was predominantly cystic(> 50%) in 73.1 %. And the majority histological classification of tumors were mature teratoma (70.3%). The motality rate was 5.5%. Three patients expired because of postpartum bleeding, post-op bleeding related complication such as DIC. SCT recurred in four patients. The interval between first and second operation was $206.2{\pm}111.0$ d (range 53~325 d). In two patients, serum AFP levels were elevated at a regular checkup without any symptom, and subsequent imaging studies revealed SCT. The most common cause of death was bleeding and bleeding related complication. So Caesarean section and active peripartum and perioperative management will be needed for huge solid SCT. In the case of Yolk sac tumor or huge immature teratoma, possibility of recurrence have to be always considered, so follow up by serial AFP and MRI is important for SCT management.

• Archives of Plastic Surgery
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• 제41권3호
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• pp.253-257
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• 2014

Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to $33.6kg/m^2$ (mean, $23.1{\pm}3.74kg/m^2$). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.