• Archives of Plastic Surgery
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• v.38 no.3
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• pp.251-256
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• 2011

Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.89-92
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• 2006

Penetrating facial wounds are uncommon and are usually life threatening because of the possibility of brain damage. There are three possible pathways for penetrating the cranium through the orbit: via the orbital roof, via the superior orbital fissure, or between the optic canal and lateral wall of the orbit. Brain injuries resulting from the penetrating wounds show extensive parenchymal damage, hemorrhage, and brain edema. Transorbital penetrating wounds can lead to diverse lesions of the optical apparatus, including the eye globe, the optical nerve, and the chiasm. Moreover, intracerebral structures may be hurt, and bleeding and infection may occur. Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of a penetrating facial wound. An 87-year-old man was admitted to the emergency department with a grinder impacted into the medial aspect of the right eye. On presentation, the man was fully conscious with a Glasgow Coma Scale score of 15 and complained of a visual disturbance of the right eye. Computed tomography demonstrated a right orbital medial and inferior wall fracture, a frontal bone fracture, and a contusional hemorrhage in frontal lobe of the brain. A craniotomy with hematoma removal and repair of the orbital floor was done. He showed no neurological deficits except right visual loss. This appears to be the first report of a man with a penetrating facial wound caused by a grinder, who presented with a potentially disastrous craniocerebral injury that did not lead to any serious neurological seguelae.

• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.295-298
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• 2017

A 6-year-old female Pekingese dog, weighing 3.85 kg was presented with regurgitation, ptyalism, weight loss and anorexia. The dog was cachexic and severely dehydrated. Physical examination of the dog confirmed upper respiratory noise, which was classified as a stridor most apparent on inspiration, respiratory effort with stenotic nares. Upper respiratory signs were thought to be caused by brachycephalic syndrome. On the lateral thoracic radiograph, the caudal one third of the esophagus was visible as a soft tissue band. CT revealed oval-shaped, soft tissue attenuating mass in size of $2.3{\times}1.0{\times}1.1cm$ arising from caudal one third of the esophagus. The mass was protruding from esophageal wall to lumen and irregular margined with heterogenous contrast enhancement. The wall of cardia and fundus was focally thickened. Gastric lymph node was enlarged with contrast enhancing. On histopathologic examination, esophageal mass was confirmed as papillary adenocarcinoma, and the gastric sample showed the same result. In human, adenocarcinoma commonly occur in esophagus and cardia, but it has not been commonly reported in veterinary medicine. This report described computed tomographic features of adenocarcinoma of the esophagocardia region in a Pekingese dog with brachycephalic syndrome.

• Imaging Science in Dentistry
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• v.38 no.2
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• pp.81-87
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• 2008

Purpose: To investigate the relationship between 3D bone architectural parameters and direction-related elastic moduli of cancellous bone of mandibular condyle. Materials and Methods: Two micro-pigs (Micro-$pig^R$, PWG Genetics Korea) were used. Each pig was about 12 months old and weighing around 44 kg. 31 cylindrical bone specimen were obtained from cancellous bone of condyles for 3D analysis and measured by micro-computed tomography. Six parameters were trabecular thickness (Tb. Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI), degree of anisotropy (DA) and 3-dimensional fractal dimension (3DFD). Elastic moduli of three orthogonal directions (superior-inferior (SI), medial-lateral (ML), andterior-posterior (AP) direction) were calculated through finite element analysis. Results: Elastic modulus of superior-inferior direction was higher than those of other directions. Elastic moduli of 3 orthogonal directions showed different correlation with 3D architectural parameters. Elastic moduli of SI and ML directions showed significant strong to moderate correlation with BV/TV, SMI and 3DFD. Conclusion: Elastic modulus of cancellous bone of pig mandibular condyle was highest in the SI direction and it was supposed that the change into plate-like structure of trabeculae was mainly affected by increase of trabeculae of SI and ML directions.

• Journal of Korean Neurosurgical Society
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• v.54 no.2
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• pp.128-131
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• 2013

Transforaminal lumbar interbody fusion (TLIF) is commonly used procedure for spinal fusion. However, there are no reports describing anterior cage dislodgement after surgery. This report is a rare case of anterior dislodgement of fusion cage after TLIF for the treatment of isthmic spondylolisthesis with lumbosacral transitional vertebra (LSTV). A 51-year-old man underwent TLIF at L4-5 with posterior instrumentation for the treatment of grade 1 isthmic spondylolisthesis with LSTV. At 7 weeks postoperatively, imaging studies demonstrated that banana-shaped cage migrated anteriorly and anterolisthesis recurred at the index level with pseudoarthrosis. The cage was removed and exchanged by new cage through anterior approach, and screws were replaced with larger size ones and cement augmentation was added. At postoperative 2 days of revision surgery, computed tomography (CT) showed fracture on lateral pedicle and body wall of L5 vertebra. He underwent surgery again for paraspinal decompression at L4-5 and extension of instrumentation to S1 vertebra. His back and leg pains improved significantly after final revision surgery and symptom relief was maintained during follow-up period. At 6 months follow-up, CT images showed solid fusion at L4-5 level. Careful cage selection for TLIF must be done for treatment of spondylolisthesis accompanied with deformed LSTV, especially when reduction will be attempted. Banana-shaped cage should be positioned anteriorly, but anterior dislodgement of cage and reduction failure may occur in case of a highly unstable spine. Revision surgery for the treatment of an anteriorly dislodged cage may be effectively performed using an anterior approach.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.295-301
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• 2015

Background Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. Methods Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. Results Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. Conclusions Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.19-25
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• 2017

Background Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. Methods We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. Results A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. Conclusions Our condylar repositioning method using a centric relation splint and miniplate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.73-77
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• 2017

An 81 year-old male patient presented with rapid enlargement of left lateral neck mass, diagnosed two months earlier as cervical nontuberculous mycobacterial lymphadenitis. Abscess formation and impending rupture related to aggravation of nontuberculous mycobacterial lymphadenitis was highly suspected. Unexpectedly, blood flow was detected by Doppler ultrasonography, which indicated possible vascular mass. Computed tomography demonstrated a $6.0cm{\times}4.0cm$ sized enhancing mass consistent with pseudoaneurysm of internal carotid artery. The patient underwent pseudoaneurysmectomy. Surgical drainage without adequate evaluation might have led to potentially life-threatening condition. We describe this rare case with importance of imaging screening in a neck mass.

• Journal of Trauma and Injury
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• v.31 no.2
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• pp.82-86
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• 2018

Craniocerebral gunshot injuries (CGIs) are extremely seldom happened in Korea because possession of individual firearm is illegal. So, CGIs are rarely encountered by Korean neurosurgeons or Korean trauma surgeons, though in other developing countries or Unites states of America their cases are indefatigably increasing. Management goal should focus on early aggressive, vigorous resuscitation. The treatments consist of immediate life salvage through correction of coagulopathy, intracranial decompression, prevention of infection and preservation of nervous tissue. There have been few studies involving penetrating CGIs in Korea. Here we present a case of penetrating gunshot wound in Korea. We present a 58-year-old man who was unintentionally shot by his colleague with a shotgun. The patients underwent computed tomography (CT) for assessment of intracranial injury. The bullet passed through the left parietal bone and right lateral ventricle and exited through the posterior auricular right temporal bone. After CT scan, he arrested and the cardiopulmonary resuscitation was conducted immediately. But we were unable to resuscitate him. This case report underscores the importance of the initial clinical exam and CT studies along with adequate resuscitation to make the appropriate management decision. Physicians should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators.

• The Korean Journal of Cytopathology
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• v.13 no.2
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• pp.78-83
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• 2002

We report the cytologic features of a case of primary small cell carcinoma of the urinary bladder with high grade transitional cell and signet ring cell carcinomatous components. A 64-year-old male presented with gross hematuria for one week. Computed tomography revealed an ill-defined mass in the left lateral wall of the urinary bladder. Urinary cytology showed hypercellularity with predominantly isolated single cells and clustered cells. They have scanty cytoplasm and naked hyperchromatic nuclei with finely granular nuclear chromatin and rare nucleoli. The tumor cells occurred predominantly singe cells, but a few in clusters. Nuclear molding was prominent. No glandular formation or nesting was noted. The second tumor cells had high nuclear/cytoplasmic ratio, irregular nuclear membrane, and coarse granular chromatin. The background was inflamed and necrotic. The histoiogic findings of transurethral resection were mainly composed of small cell carcinoma, and partly transitional cell and signet ring cell carcinomatous components. Small cell neuroendocrine carcinoma have distinctive cytologic features to make a proper diagnosis.