• Title/Summary/Keyword: 비강 수술

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ECTOPIC CANINES INTO THE MAXILLARY SINUS (상악동으로 이소맹출한 견치)

  • Kim, Hyun-Ok;Choi, Byung-Jai;Lee, Jong-Gap
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.4
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    • pp.535-539
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    • 2000
  • Ectopic eruption of a tooth into the oral environment occurs commonly whereas ectopic eruption of a tooth into other sites is rare. Those that have been reported include the nasal cavity, chin, mandibular condyles, coronoid processes, orbits and maxillary sinus. The etiologic factors of ectopic eruption are developmental disturbances such as cleft palate and teeth displaced by trauma or cysts, maxillary infection, genetic factors, crowding and exceptionally dense bone. In many cases, however, the etiology cannot be identified. Eruption of the teeth into the maxillary sinus is uncommon, however the identification of such teeth can be important since they have the potential to cause considerable morbidity. The definitive treatment is surgical removal of the teeth. A 7 year-old-boy visited the Department of Pediatric Dentistry, College of Dentistry, Yonsei University for treatment of dental caries. The abnormal erupting paths of the left and right maxillary canines were found during routine panoramic radiographic investigations. A panoramic radiograph taken at 13 years old revealed that two maxillary canines were located into the sinus. The teeth were extracted by the Caldwell-Luc approach.

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The clinical study for the postoperative tracheal stenosis (수술후성 기관협착증에 관한 임사적 고찰)

  • 김기령;홍원표;이정권
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.9.1-10
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    • 1977
  • Many etiological factors playa significant role in the development of tracheal stenosis; too high tracheostomy (Jackson, 1921), too small stoma (Greisen, 1966), the treatment with respirator using cuffed tube (Pearson et al., 1968; Lindholm, 1966; Bryce, 1972) and infection (Pearson, 1968). Although the incidence has been reduced due to development of surgical technique and antibiotics, the frequency of tracheal stenosis which produces symptoms after tracheostomy ranges from 1.5 per cent (Lindholm, 1967). In the management of the stenosis, mild cases are treated by mechanical dilatation with silicon tube or stent (Schmigelow, 1929; Montgomery, 1965) combined steroid (Birck, 1970), and in the cases of stenosis causes, these removed under the are bronchoscopy. But in severe stenosis, transverse resection with subsequent end-to-end anastomosis has been used in recent years (Pearson et al., 1968). During about 10 years, 1967 to 1977, a total of 23 patients with tracheal stenosis complicated among the 1, 514 tracheostomies have been treated in Severance Hospital. Now, we have obtained following conclusions by means of clinical analysis of 23 cases of tracheal stenosis. 1. The frequency of tracheal stenosis was 23 cases among 1, 514 cases of tracheostomy (1.5%). 2. Under the age of 5, these are 12 cases (52.2 %). 3. The sex incidence was comprised of 18 males and 5 females. 4. The duration of tracheostomy ranges from 4 days to 16 months. 5. The primary diseases requiring tracheostomy were following; central nerve system lesions 11 cases, upper air way obstruction 10 cases, extrinsic respiratory failure 2 cases. 6. Severe wound infections were only 2 cases. 7. The methods of treatment applied to tracheal stenosis were following; closed observation only 5 cases, nasotracheal intubation combined steroid 5 cases, T-tube stent combined steroid 3 cases, fenestration op. 4 cases, revision 4 cases and transverse resection and end-to-end anastomosis 2 cases.

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Adenoid Cystic Carcinoma of the Head and Neck (두경부의 Adenoid Cystic Carcinoma)

  • 박준식;설대위
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.14.2-14
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    • 1981
  • In 1859, Billroth used the term "Zylindrome" to describe a tumor arising in the paranasal sinuses. This neoplasm has been referred to by a variety of terms including cylindroma, basaloma, basaloid adenoma, cribriform adenocarcinoma, and "adenoid cystic carcinoma", now preferred by most authors. It most often arises in the major and minor salivary glands of the head and neck but has been noted in the trachea, lung, breast, skin and elsewhere. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after agrressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief as a palliative treatment. The present study was undertaken to review our experience with a group of 44 patients with adenoid cystic carcinoma of the head and neck, diagnosed at the Jeonju Presbyterian Medical Center between 1963 and 1980. The results are as follows: 1. Forty-four cases of adenoid cystic carcinoma represented 40% of the malignant salivary gland tumors during the same interval. 2. The most common primary sites were palate(8 cases) and submandibular gland (8 cases). 3. Thirteen patients (31%) had tumors. that arose in the major salivary glands; 29 (69%), minor salivary glands. 4. Of the 44 patients, there were 21 males. and 23 females. 5. Age at diagnosis ranged from 19 to 78 years; the average age was 50 years. 6. The tumor size was more than 4cm to 6cm in its greatest diamension in 10 patients. Clinically positive cervical lymph nodes were found in 7 patients; distant metastasis in one case at the time of diagnosis. 7. Radical excision was employed in 27 patients, 14 of whom combined with radiotherapy. 8. Of 29 patients available for follow-up the gross and determinate 3-year survival rates were 27.6% and 44.4%, respectively. Among twelve patients who received radical excision, the 3-year survival was 58%. 9. Ten of these 44 patients had local recurrence in an interval of 3 to 88 months. from the initial treatment. Of ten recurrences, 3 occured after 5 years. 10. Distant metastasis was found in 3 of the treated patients. All were pulmonary metastasis.

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Effect of Splenectomy on Development of Primary Amoebic Meningoencephalitis (비장적출(splenectomy)이 원발성 아메바성 뇌수막염의 발생에 미치는 영향)

  • Sin, Ho-Jun;Im, Gyeong-Il;Choe, Rim-Sun
    • Parasites, Hosts and Diseases
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    • v.23 no.1
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    • pp.156-164
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    • 1985
  • To elucidate the effect of splenectomy on the development of experimental primary amoebic meningoencephalitis in mice, the death rate and survival time of mice infected intranasally with Naegleria fowleri trophozoites $5{\times}10^4$ cultivated in CGVS medium were compared according to the mouse age when splenectomy was done, and post-operation until experimental infection. Immunodigusion was undergone to detect the presence of serum antibod). due to N, fowleri infecttion in mice. Polyacrylamide gel electrophoresis was done to compare the protein fractions of mouse serum in each experimental groups. In experiment I, splenectomy was done 3 weeks and infection 4 weeks after birth, the death rate of control, sham operated and splenectomized group were 100%, 85% and 95%, and the mean survival time after infection 7.3 days, 7.5 days and 7.8 days, respectively. In experiment II, splenectomy was undergone 3 weeks and infection 6 weeks after birth, the death rate of of control, sham operated and splenectomized group were 95%, 95% and 95%, and the mean survival time after infection 12.1 days, 11.5 days and 11.5 days, respectively. In experiment III, splenectomy was done 5 weeks and infection 6 weeks after birth, the death rate of control, sham operated and splenectomized group were 95%, 90% and 95%, and the mean survival time after infection 8.1 days, 8.3 days and 8.5 days, respectively. By Ouchterlony immunodigusion, anti-JV. fowleri antibody in the serum of mouse with primary amoebic meningoencephalitis was detected against a N. fowleri antigen, which was prepared by ultrasonication of N, fowleri trophozoites, each reacting two lines of precipitation. The patterns of serum fractions by polyacrylamide gel electrophoresis were different between control and sham operated groups from splenectomized group in fraction II, III and V, the sera of which were collected after N. fowleri infection. This results may be summarized as that splenectomy has no effect on the development of primary amoebic meningoencephalitis in mice.

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FACIAL ASYMMETRY OF UNILATERAL CLEFT LIP AND PALATE PATIENTS (편측성 순구개열자의 안면비대칭에 관한 연구)

  • Son, Woo-Sung;Kim, Mi-Kyung
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.13-18
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    • 1995
  • Craniofacial asymmetry was analyzed in 39 patients with complete unilateral cleft lip and palate(UCLP). The samples are devided into three groups nine below 9 years, twenty three from 9 years 1 month to 14 years and seven over 14 years group. Seventeen measurements were obtained from the tracing of PA X-ray cephalometric headfilms to evaluate the asymmetric characteristics and changes accdording to aging in UCLP. The obtained results were as follows. 1. Facial asymmetry in UCLP is variable(1.22-3.47 $mm/^{\circ}$) and the length from midsagitta1 reference line to maxillary 1st molar, to upper central incisor and the length of mandibular ramus showed significant asymmetry 2. Nasal septum and anterior nasal spine were deviated In the cleft side and the lower border of nasal cavity was 1ower in cleft side. 3. The deviation of nasal septum was continued significantly till after 14 years old.

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A Case of Metastatic Oral Carcinoma from Rectal Cancer (직장암 유래 전이성 구강 암종의 진단예)

  • Shin, Keum-back;Kang, Kee-hyun;Chae, Gyu-sam
    • Journal of Oral Medicine and Pain
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    • v.24 no.2
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    • pp.171-179
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    • 1999
  • The authors experienced a oral carcinoma involving the medial cortex of the right ramus of mandible and the left side of the maxilla which was metastasized from primary rectal adenocarcinoma based on the comprehensive evaluation of data obtained from (1) the past medical history of primary rectal adenocarcinoma, (2) the computerized tomographic views of the homogeneous mass on the anteromedial region of the right ramus of mandible destructing the medial cortex of the right ramus of mandible, and the irregular mass around the clivus spreading into the sphenoid sinus and destructing the left side of the maxilla ; the bone scanning of hot spots on the nasal region and the left side of maxilla ; the posteroanterior chest radiographic view of multiple nodular radiopacities on the lung, (3) the retrospective review of the sonographic view of a hypoechoic, well-demarcated, target-like mass with central hyperechoic focus on right lobe of liver in a Korean female of 49-year-old who complained the ptosis of left eyelid, the swelling on left zygomatic area, the left facial paralysis, the facial asymmetry and a round-shaped, elevated lesion with a hematoma on the mucosa covering the right ramus of mandible.

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Reconstruction of Pharyngoesophageal Defects Using free Flaps (유리 피판을 이용한 인두식도 결손의 재건)

  • Moon, Ji-Hyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.154-162
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    • 1999
  • The laryngopharyngectomy for tumor ablation is the most common indication for pharyngoesophageal reconstruction in our country. Most of these cases are advanced laryngeal cancer that has spread beyond the larynx, pharynx and cervical esophagus. Such patients are obviously unable to breathe, swallow, or speak in the normal manner. The ideal reconstruction would restore normal anatomy, permitting patients to breathe and swallow without aspiration, and would not require a permanent tracheostomy. Reconstruction of the pharyngoesophageal defect traditionally been carried out with tubed local random flap, deltopectoral or musculocutaneous flap. Another approach is the pedicled enteric flap. But microsurgical reconstruction of the pharyngoesophagus, using either the free jejunal or the tubed radial forearm flap, have now become the preferred technique. Among them, we used jejunal free flap in 39 cases, tubed radial forearm free flap in 5 cases, patched radial forearm free flap in 2 cases and pectoralis major myocutaneous island flap in 2 cases from December 1990 to Febrary 1999. In this paper we illustrated that both forearm and jejunal free flap is a usful alternative in reconstruction of hypopharynx and cervical esophagus.

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Herbst Oral Appliance for Obstructive Sleep Apnea When Uvulopalatopharyngoplasty and Nasal CPAP Failed (구개수구개인두성형술 및 지속적 기도 양압 공급치료에 실패하였으나 Herbst 구강내 장치로 효과를 보인 폐쇄성 수면 무호흡 증후군 1예)

  • Moon, Hwa-Sik;Choi, Young-Mee;Kim, Myung-Lip;Park, Young-Hak;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.457-464
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    • 1998
  • This report describes a 5-month follow-up of the efficacy of Herbst oral appliance(OA) in a obstructive sleep apnea syndrome patient who has failed with uvulopalatopharyngoplasty(UPPP) and was unable to tolerate to subsequent nasal continuous positive airway pressure(CPAP) because of mouth air leak. The obstructive sleep apnea and daytime performance were markedly improved by regular home use of OA, and the patient still continues to use OA without complications. It is suggested that OA can be a successful alternative therapeutic modality in patients who are unable to tolerate to nasal CP AP, especially after UPPP.

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Perioperative Orbital Volume Change in Blowout Fracture Correction through Endoscopic Transnasal Approach (안와파열골절의 비강내 내시경적 접근을 통한 교정에서 수술 전후 안와 용적 변화)

  • Lee, Jae Woo;Nam, Su Bong;Choi, Soo Jong;Kang, Cheol Uk;Bae, Yong Chan
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.617-622
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    • 2009
  • Purpose: Endoscopic transnasal correction of the blowout fractures has many advantages over other techniques. But after removal of packing material, there were some patients with recurrence of preoperative symptoms. Authors tried to make a quantitative anterograde analysis of orbital volume change over whole perioperative period which might be related with recurrence of preoperative symptoms. Methods: 10 patients with pure medial wall fracture(Group I) and 10 patients with medial wall fracture combined with fracture of orbital floor(Group II) were selected to evaluate the final orbital volume change, who took 3 CT scans, pre-, postoperative and 4 months after packing removal. By multiplying cross - section area of orbit in coronal view with section thickness, orbital volume were calculated. Then, mean orbital volume increment after trauma, mean orbital volume decrement after endoscopic correction and volume increment after packing removal were found out. And we tried to find correlations between type of fracture, initial correction rate and final correction rate. Results: The mean orbital volume increment of the fractured orbits were 7.23% in group I and 13.69% in group II. After endoscopic surgery, mean orbital volume decrement were 11.0% in group I and 12.46% in group II. Mean volume increment after packing removal showed 3.10% in group I and 6.50% in group II. The initial correction rate(%) showed linear correlation with final correction rate(%) after packing removal. And there were negative linear correlation between increment percentage of orbital volume by fracture and final correction rate(%). Conclusion: Orbital volume was proved to be increasing after removal of packing or foley catheter and it was dependent upon type of fracture. Overcorrection should be done to improve the final result of orbital blowout fracture especially when there are severe fracture is present.

Role of Crural Diaphragm after Esophagogastrectomy (식도-위 절제술 후 횡격막 crura의 역할)

  • 조성래;하현철;이봉근;조봉균
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.763-768
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    • 2001
  • Background: The high pressure zone(HPZ) at the gastroesophageal junction is an important barrier for prevention of gastroesophageal reflux. Smooth muscle layers in the lower esophageal sphincter mainly contributes to HPZ at the throacoabdominal junction. The purpose of this study was to investigate the manometric characteristics of the thora-coabdominal junction in patients after surgical removal of the lower esophageal sphincter. Material and Method: Twenty two patients with prior esophagogastrectomy(10 Ivor-Lewis method and 12 left thoracotomy) and 30 normal adults(control group) were studied manometrically. Result: Esophageal manometry showed a HPZ and pressure inversion points distal to the anastomosis in 12 of 22 patients(2 of 10 patients with Ivor-Lewis method and 10 of 12 patients with left thoracotomy) and a HPZ in 30 of 30 normal adults. The location of HPZ front nostril was not significant different between the two groups(42.5$\pm$0.9cm in patients and 43.9$\pm$2.1cm in the control), while the length of HPZ was shorter in patients than in the control(2.13$\pm$0.6cm vs 2.83$\pm$0.59cm). By SPT and RPT, pressures of HPZ at rest were lower in patients(13.78$\pm$1.63mmHg, 28.58$\pm$6.06mmHg) than in control(20.3$\pm$4.95mmHg, 42.80$\pm$15.91mmHg). The HPZ relaxed partially in response to deglutition(84.4% in patient, 90.5% in control group) and contracted in response to increased intra- abdominal pressure induced by leg lifts(HPZ/ Intra-abdominal pressure= 1.81$\pm$0.23 in patient, 2.13$\pm$ 0.58 in control group).

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