• Archives of Plastic Surgery
• /
• v.38 no.4
• /
• pp.512-515
• /
• 2011

Purpose: Osteoma is one of the common benign tumors of the skull vault and facial skeleton. Although most of the osteomas cause no symptoms, forehead osteomas may lead to facial disfigurement. Osteoma usually happens in solitary lesion and multiple osteomas which don't combine with syndrome are very rare. We report an experience of treatment of non-syndromic multiple osteomas in the skull. Methods: A 54-year-old female patient visited due to the multiple palpable hard masses on her forehead in 2010. In 2002 of her first visit, masses started to appear on her forehead and she was diagnosed as the osteoma by excisional biopsy. She visited again because the mass size and number increased. In preoperative CT scanning, there were above 160 of osteomas, so surgery was planned. Enterogastroduodenoscopy and colonoscopy was conducted to rule out Gardener's syndrome, however there was no abnormality such as multiple polyposis. Results: Under general anesthesia, coronal approach was conducted. There were numerous osteomas in frontal and parietal bone. The multiple osteomas were removed by burring and the patient recovered without any postoperative complications. Conclusion: Multiple osteomas in the skull were rarely reported, although it can accompanied with Gardener's syndrome. We report a case of non-syndromic multiple osteomas in skull vault.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.sup1
• /
• pp.91-98
• /
• 2001

Objective : The purpose of this study was to investigate the prognostic factors in patients who suffered an intracerebral hemorrhage(ICH) due to a ruptured middle cerebral artery(MCA) aneurysm. Methods : Among 148 case of ruptured MCA aneurysm, ruptured MCA aneurysm with ICH was compared with ruptured MCA aneurysm alone. According to factors, the prognosis in these two groups was analyzed. Prognosis was evaluated postoperatively by applying Glasgow Outcome Scale(GOS) at discharge. Prognostic factors were evaluated with Chi square test, Mann-Whitney test and ANOVA test with differences being considered significant for value less than 0.05. Results : Ruptured MCA aneurysm alone revealed better consciousness on admission and final outcome than those combined with ICH. Ruptured MCA aneurysm alone showed 74% in H-H grade I, II and 82% in GOS I, II. But ruptured MCA aneurysm with ICH showed 63% in H-H grade IV, V and 52% in GOS IV, V. Age, sex, lesion site, aneurysmal size, temoporary clipping time, interval to operation, operative approach were statistically not significant in prognosis(p>0.05). But H-H grade on admission(p<0.05), complication(esp. cerebral infarction)(p<0.05), preoperative ICH volume and site(p<0.01), preoperative midline shifting(p<0.01), remained ICH volume(p<0.05) showed significance statistically. Conclusion : Prognostic factors are helpful to neurosurgeon to estimate clinical and neurological outcome postoperatively. We suggest that the good prognostic factors in ruptured MCA aneurysm with ICH were good H-H grade on admission, cerebral infarction(-), preoperative ICH volume <25cc, temporal and intrasylvian ICH, preoperative midline shifting <5mm, remained ICH volume <10cc.

• Journal of Korean Neurosurgical Society
• /
• v.60 no.1
• /
• pp.114-117
• /
• 2017

A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess. At admission to our department, the patient reported aggravated low back pain. Blood test results, including the erythrocyte sedimentation rate and C-reactive protein levels, were slightly elevated. Biopsy samples of the L4, L5 vertebral bodies and disk were obtained. The material underwent aerobic, anaerobic, fungal, mycobacterial cultures and histologic examination. Results of all cultures were negative. Histologically, necrosis of the bone was evident from the number of empty osteocyte lacunae. In addition, there was no evidence of infection based on biopsy results. No antibiotic treatment was administered on discharge. Repeat computed tomography and MRI performed 12 months after IDET showed a bony defect in the L4 and L5 vertebral bodies, and a decrease in the size of the L4-5 intervertebral disc lesion. We report a case of lumbar vertebral osteonecrosis induced by IDET and discuss etiology and radiologic features.

• Acute and Critical Care
• /
• v.33 no.4
• /
• pp.276-279
• /
• 2018

In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries that require general anesthesia. No esophageal injury has been reported after insertion of an LMA. We report a case of an esophageal injury with intramural dissection after an $i-gel^{(R)}$ (size, 1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to insert an $i-gel^{(R)}$. However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus in pediatric patients.

• Journal of Oral Medicine and Pain
• /
• v.44 no.1
• /
• pp.1-10
• /
• 2019

Purpose: The aim of this study was to evaluate the optimal doses of intralesional triamcinolone acetonide (TA) in the treatment of oral lichen planus (OLP). Methods: A randomized clinical trial was performed. Sixty-two lesions of OLP were received 12 mg (group A) or 20 mg (group B) of TA intralesionally weekly for 2 weeks. Subjective symptoms, lesion size, favorable conversion of clinical subtypes, and clinical response were evaluated at weeks 0, 1, 2, and 4. Results: After two consecutive injections of TA, group B showed significant reduction in burning sensation and reticular area (p<0.01). Favorable conversion and complete response were greater in group B. Mild oral candidiasis was developed in group B (10.7%). Conclusions: A 20-mg injection of TA was much more effective compared with 12-mg injection of TA in the treatment of OLP.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.24 no.2
• /
• pp.212-218
• /
• 2020

There are dozens of different types of lesions that can be diagnosed through chest X-ray images, including Atelectasis, Cardiomegaly, Mass, Pneumothorax, and Effusion. Computed tomography(CT) test is generally necessary to determine the exact diagnosis and location and size of thoracic lesions, however computed tomography has disadvantages such as expensive cost and a lot of radiation exposure. Therefore, in this paper, we propose a deep learning algorithm for judging the presence or absence of lesions in chest X-ray images as the primary screening tool for the diagnosis of thoracic lesions. The proposed algorithm was designed by comparing various configuration methods to optimize the judgment of presence of lesions from chest X-ray. As a result, the evaluation rate of lesion presence of the proposed algorithm is about 1% better than the existing algorithm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.2
• /
• pp.112-119
• /
• 2021

Objectives: Myxomatous odontogenic tumors (MOTs) are the third most common odontogenic tumors in the oral and maxillofacial region. Due to its slow-growing, but locally invasive nature, the tumor is usually detected by accident or only when it becomes a large mass, which causes facial deformity. Materials and Methods: Current study reports three unusual cases of MOT including huge myxoma involve the mandible in middle-aged man, MOT with ossifying fibroma pattern in mandible, and MOT in maxilla of young female patient. The diagnosis and treatment strategy of MOTs was also summarized and updated. Results: In reported three cases of patients with large MOTs, surgical treatment was indicated with fibular free flap reconstruction in the mandible and plate reconstruction in the maxilla. The tumors were successfully treated with radical resection and did not show signs of recurrence during the follow-up period. Conclusion: Surgical treatment indication depends on size, the position of the lesion, patient systemic condition and surgeon individual experience. In the case of a large tumor, radical resection and reconstruction is the standard surgical strategy. The conservative surgical treatment including enucleation with wide curettage is still under controversy. The recurrence rate for MOTs is significantly high, up to 30%, therefore long-term follow-up is essential.

• Journal of Chest Surgery
• /
• v.55 no.6
• /
• pp.462-469
• /
• 2022

Background: Carotid endarterectomy (CEA) is used to treat carotid stenosis, which is associated with cerebral infarction and may result in neurologic deficits such as stroke, transient ischemic attack (TIA), and local nerve injury. To decrease surgery-related complications and improve patient satisfaction with esthetic outcomes, efforts have been made to minimize incision size instead of using a standard longitudinal incision. Methods: We performed a retrospective analysis of 151 cases of CEA, of which 110 used conventional incisions and 41 used high mini-skin incisions (HMIs), from March 2015 to December 2021 at a single institution. Short-term (30-day) postoperative results were evaluated for rates of mortality, stroke, TIA, and cranial/cervical nerve injuries. Risk factors for nerve injury were also assessed. Results: The HMI group showed significantly (p<0.01) shorter operative and clamp times than the conventional group. The HMI group also had significantly shorter incision lengths (5.3±0.9 cm) than the conventional group (11.5±2.8 cm). The rates of stroke, TIA, and death at 30 days were not significantly different between the 2 groups. There was no significant difference in the rate of cranial and cervical nerve injuries, and all injuries were transient. A high lesion level (odds ratio [OR], 9.56; 95% confidence interval [CI], 3.21-28.42; p<0.01) and the clamp time (OR, 1.07; 95% CI, 1.03-1.12; p<0.01) were found to be risk factors for nerve injuries. Conclusion: Use of the HMI in CEA for carotid stenosis was advantageous for its shorter operative time, shorter internal carotid artery clamp time, reduced neurologic complications, and improved esthetics.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.2
• /
• pp.110-114
• /
• 2022

IgG4-related disease is a fibroinflammatory condition by infiltration of IgG4-positive plasma cells that often presents as a tumorous lesion. This disease can affect nearly every organ system. After the pancreas, the head and neck region is second most common site for presentation of IgG4-related disease such as Mikulicz's disease, Küttner tumor. The involvement of IgG4-related disease in laryngeal lesions is extremely rare. We have experienced a case of IgG4-related disease with pseudotumor formation in the larynx that is suggestive of malignancy in radiologic findings. But the pathology findings was finally confirmed as IgG4-related disease. Oral treatment with prednisolone was initiated, and the edematous mass reduced in size without permanent functional impairment of vocal fold mobility. We report our experience with a literature review.

• Journal of dental hygiene science
• /
• v.23 no.2
• /
• pp.88-92
• /
• 2023

Background: Aphthous stomatitis is a common disease of the oral mucosa and its pathogenesis is associated with several risk factors. Frequently, minor ulcers are idiopathic in nature and often resolve naturally. However, those ulcers are painful and sensibly compromise patients' eating. There are different treatment strategies for the clinical management of oral aphthae. Methods: The present study assessed the efficacy of a film-forming cream in accelerating the healing and diminishing the pain associated with minor aphthae in a randomized fashion design. The test product (AphtoFix^®) was compared with placebo cream in a cohort of patients with a diagnosis of minor recurrent stomatitis. Patients were randomly distributed into two groups and were followed for 10 days. The primary outcomes included the number of days until symptoms were relieved and the number of days to complete healing. Results: Thirty-six patients completed the follow-up, eighteen per group. All lesions eventually healed within day 10. However, patients in the test group experienced significantly less pain, already from day 1. Patients in the test group also showed a faster healing rate of the lesion with an average of 7 days against the 9 days required for patients in the control group. Conclusion: The present study supported the utility of a film-forming in cream in relieving the patient from symptoms associated with aphthous stomatitis already at day 1 of product use. Patients also displayed faster healing of the lesions when compared to the control group. Further studies with greater sample size and patient stratification according to age and risk factors are recommended to support the present findings.