• Title/Summary/Keyword: 수술 후 감염

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MRI Findings of Intramuscular Foreign Body Injection: A Case Report (근육 내 이물질 주사의 자기 공명 영상 소견: 증례 보고)

  • So, Seong Yong;Kim, Hyun-Joo;Choi, Deuk Lin;Hong, Seong Sook;Chang, Yun-Woo;Park, Sung Tae
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.1
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    • pp.59-62
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    • 2013
  • There are various types of foreign body reactions, such as inflammation, edema, fluid collection, hematoma, infection, abscess and granulomas. There are various imaging findings according to types of foreign bodies and depending on the lapse of time. Therefore, correct diagnosis of a foreign body reaction is difficult and easily confused with soft tissue neoplasm. The MRI is ideal for the detection of foreign bodies regardless of radiolucency or acoustic impedance. It is especially very useful in the evaluation of the surrounding tissue reaction. The authors report a case of a 26-year-old female patient with both forearm swelling due to self-injection of a mixture of powdered tablets and saline. The lesion shows numerous internal T1 and T2 dark signal intensity micro-spots with surrounding fluid collection, which are diagnosed as foreign bodies with surrounding inflammatory changes during an operation.

THE EFFECTIVENESS OF POST OPERATIVE ADMINISTRATION OF ANTIBIOTICS IN ORTHOGNATHIC SURGERY: INFECTION FREQUENCY BASED ON POST-SURGICAL APPLICATION OF ANTIBIOTICS (악교정 수술후 항생제 투여의 효용성 : 술후 항생제 투여 여부에 따른 창상감염 빈도)

  • Kang, Sang-Hoon;Yoo, Jae-Ha;Yi, Choong-Kook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.206-210
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    • 2007
  • This study observed the frequency of post-surgical infection according to post-surgical application of antibiotics in order to evaluate the benefits of the use of antibiotics after the orthognathic surgery. 349 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The mean(SD) age of the 349 patients was 22.7(${\pm}4.25$) with a male-female ratio of 168:181. 226 patients received only 1.0g of a third-generation cephalosporin(Cefpiramide) intravenously 30 minutes prior to the surgery. Likewise, 123 patients received 1.0g of Cefpiramide 30 minutes prior to the surgery and twice daily longer than the third day after surgery. The mean(SD) duration of administration was 4.75(${\pm}0.89$) day. The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. However, 14 patients of 226 patients received antibiotics only prior to the surgery developed postoperative infection, 2 patients of 123 patients received antibiotics longer than postoperative 3 days developed postoperative infection. Postoperative infection frequency showed no significant difference between the two groups(p=0.094). Also, bi-maxillary operation and mandibular operation alone, showed no significant difference in the frequency of post-surgical infection when antibiotics had been continuously used after the surgery. From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

A Case of Carotid Artery Pseudoaneurysm Misdiagnosed as Aggravation of Non-tuberculous Mycobacterial Lymphadenitis (비정형 결핵성 림프절염의 악화로 오인된 경동맥 가성동맥류 1예)

  • Noh, Woong Jae;Lee, Hyoung Shin;Kim, Sung won;Lee, Kang Dae
    • 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.

Microvascular Reconstruction of Extensive Foot Injuries (유리피판술을 이용한 족부재건)

  • Chung, Yoon-Kyu;Chung, Seum;Kim, Joo-Bong
    • Archives of Reconstructive Microsurgery
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    • v.3 no.1
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    • pp.64-71
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    • 1994
  • The successful treatment of the extensively traumatized foot warrants reconstruction utilizing tissue that will provide adequate coverage, is resistant to infection, thin enough to conform to the contours of the foot as well as durable to constant frictional movement and weight bearing. Currently, free flaps offer the best means in achieving these difficult and sometimes contradictory goals. We treated twenty-one patients suffering from extensive soft tissue loss of the foot due to trauma, electric burn or postburn sequelae with free flaps. A fasciocutaneous, musculocutaneous or muscle flap with skin grafting was used based on the location, volume of tissue required, and the functional anatomical requirement of the injured region. The follow-up duration averaged twenty-nine months. From our group of patients, we believe that the muscle free flap with skin grafting offers the most favorable outcome.

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A Case of Struvite Urolithiasis in a One-month-old Korean Sapsal Dog (1개월령 삽살개에서 발생한 Struvite요도결석 1례)

  • Oh, Won-Seok;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.453-456
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    • 2010
  • A one-month-old, 0.9 kg BW, male Korean Sapsal dog with anorexia, anuria, ataxia and depression was referred. On physical examination, the dog was showed tachycardia, hypothermia and pale mucous membrane. Hematologic values showed leukocytosis and mild anemia. Serum chemistry profile results revealed increased BUN (57.3 mg/dl) and $NH_3$ ($584\;{\mu}g/dl$), decreased albumin, sodium and potassium. Urinalysis showed hematuria, proteinuria, glucosuria, bacteriuria (Staphylococcus spp.) and magnesium ammonium phosphate crystalluria. On radiographic finding, urinary bladder was enlarged and 2 mm diameter radiopaque urolith was showed between os penis and prescrotal region. Urolithiasis was surgically corrected by urethrostomy.

A CASE REPORT OF SURGICAL CORRECTION OF NASOMAXILLARY HYPOPLASIA DUE TO CONGENITAL SYPHILIS BY LE FORT II OSTEOTOMY WITH CORONAL APPROACH (선천성 매독에의한 비상악골 부전증환자의 관상두피 접근법에 의한 Le Fort II 골절단술을 이용한 치험례)

  • Um, In-Woong;Kim, Chang-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.88-94
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    • 1991
  • Maxillofacial deformities are not considered to be a trouble in social life but function. So many maxillofacial plastc surgeons has made efforts to overcome these troubles and bring out more positive life. The proper proportion and shape decide esthetic quality. Lower third of face was consist with lip, cheek, mandibular lower border and mandibular angle. Widening lower third of face give a impression with muscular and recklessness. And lower and wide mandibular angle makes face square shape. Unilateral involvement cause asymmestric face. These face is considered unfavorable, especially in Korea or Japan. We prevent a number of with mandibular angle Bulging which was corrected with mandibular osteotomy or masseter myotomy.

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Analysis of Children with Unilateral Multicystic Dysplastic Kidney(MCDK) (편측성 다낭포성 신이형성증 (Unilateral multicystic dysplastic kidney)의 임상 경과)

  • Yoo Ji Hyung;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Han Sang Won;Kim Myung Joon
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.63-68
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    • 2000
  • Purpose: MCDK is regarded as a common cause of abdominal masses in children. And the presentation of the MCDK is usually a unilateral flank mass in the a newborn. Bialteral disease results in either fetal demise or necessity fer renal replacement therapy at birth. This study is designed to assess the clinical features and natural history of the unilateral multicystic dysplastic kidney. Patients and Methods: From January 1987 to January 2000 data were obtained retrospectively on 57 patients (28 boys and 29 girls, age ranged 1day-11years) who had a diagnosis of multicystic dysplastic kidney. The diagnosis of multicystic dysplastic kidney was confirmed by a combination of ultrasonography and radionuclide scan. Voiding cystourethrogram study in 31 patients were done to determine the condition of the contalateral kidney. Restllts: $84\%$ of the patients were diagnosed before birth by antenatal ultrasonography Clinical manifestations of children with postnatal diagnoses were palpable abdominal mass($3.5\%$), abdominal distension($17\%$), and incidental($10.5\%$). The abnormalities in contralateral kidney were hydronephrosis($21\%$), compensatory hypertrophy($12\%$), simple cyst($2\%$), bifid pelvis($2\%$). Surgical management was performed in 20 patients($35\%$) due to recurrent infection, for diagnostic purpose to differentiate from malignancy and abdominal distention. Follow-up in the remaining 37 patients continued (mean 18 months) and results of sonogram findings were involution change in 23 patients($40\%$) and no interval changes in 13 patient($23\%$). Conclusions : The apparent tendency to regression of the dysplastic kidney and no difference in the number of complications justify a conservative management rather than operative intervention except in associated severe complications such as urinary tract infection or rupture of cysts.

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Intraoperative Ultrasound-Guided Percutaneous Repair of a Ruptured Achilles Tendon: A Comparative Study with Open Repair (초음파 유도하 경피적 아킬레스건 봉합술: 개방적 봉합술과의 비교 연구)

  • Kang, Dong Hun;Kang, Chan;Hwang, Deuk Soo;Song, Jae Hwang;Choi, Bo Sung
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.522-529
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    • 2018
  • Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.

A Case of Epidural Abscess Complicated from Acute Mastoiditis Caused by Streptococcus pneumoniae (폐렴구균에 의한 급성 유양돌기염에서 합병된 경막외농양 1례)

  • Choi, Jee-Hyun;Kim, Min-Sung;Kim, Jong-Hyun;Son, Byung-Chul;Kim, Seong Joon;Park, So Hyun;Lee, Jung Hyun;Oh, Jin Hee;Koh, Dae Kyun
    • Pediatric Infection and Vaccine
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    • v.21 no.2
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    • pp.144-149
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    • 2014
  • Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.

Seventeen Years' Experience with Ninety-six Esophageal Atresias (선천성 식도 폐쇄증 - 17년간의 96예 치험 분석 -)

  • Chun, Yong-Soon;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.140-148
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    • 1995
  • To study the clinical profiles and outcome of surgery in infants with esophageal atresia, we reviewed 96 esophageal atresia cases who were treated from April, 1978 to June, 1995. There were 51 male and 45 female infants, a ratio of 1.1:1. The low birth weight(<2500g) patients were 32%. Clinical findings at the time of diagnosis included drooling in 57%, choking in 50%, cyanosis in 38%, respiratory distress in 27% and swallowing difficulty in 20%. Gross classification included 6 cases of type A esophageal atresia(6%), 79 cases of type C(82%), 3 cases of type E (3%) and 8 cases of type F(8%). Associated anomalies occurred in 34 infants(35%). Among them, cardiac anomalies were most common(60%). A primary repair of the defect was carried out in 76 patients with type A or C. A staged operation comprising a repair or gastric tube interposition after gastrostomy was performed in 8 patients. In all 3 infants with H-type, a division of fistula was performed. Esophageal resection and anastomosis was done in 8 infants with esophageal stenosis. In one infant, a gastrostomy was performed and he expired before staged operation. Anastomotic complications included leakage in 16 cases(17%), stricture in 37 cases(39%) and recurrent tracheoesopohageal fistula in 3 cases(3%). The mortality rate was 14% and the leading cause of death was pneumonia. The overall survival rate was 86%, and according to Waterston criteria, the survival rates were 93%, 85% and 58% in class A, Band C, respectively. 75 patients were followed up with median follow up 6.4 years. Among them, 93% were uneventful and 7% had frequent pneumonia.

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