• Title/Summary/Keyword: Anesthesia, General

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An unusual presentation of non-specific cystic degeneration of craniofacial fibrous dysplasia: a case report and review of literature

  • Hong, Inseok;Kang, Dong Cheol;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.31.1-31.7
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    • 2020
  • Background: Fibrous dysplasia (FD) is a rare, sporadic, and benign congenital condition in which normal cancellous bone is replaced by fibro-osseous tissue with immature osteogenesis. FD localized in the cranial and facial bones is called craniofacial fibrous dysplasia (CFD). Cystic degeneration in CFD cases is rare; cystic degeneration appearing in both the maxilla and the mandible FD lesion is even rarer. The aim of this article was to report a case of fibrous dysplasia of the mandible and maxilla complicated by nonspecific cystic degeneration. Case presentation: A 30-year-old woman presented with a rare case of non-specific cystic degeneration in a mandible and maxilla FD lesion that occurred 11 years after surgery. She was diagnosed with polyostotic CFD and underwent maxillary and mandibular bone contouring. Cyst enucleation under general anesthesia was performed in the mandibular region due to pain and discomfort. Conclusions: In cases involving non-aggressive and non-invasive FD cystic degeneration in focal areas, conservative treatment is recommended. However, if cystic degeneration of FD develops rapidly and causes discomfort, pain, or dysfunction, surgical treatment should be considered.

Korean Red Ginseng (Panax ginseng Meyer) with enriched Rg3 ameliorates chronic intermittent heat stress-induced testicular damage in rats via multifunctional approach

  • Kopalli, Spandana Rajendra;Cha, Kyu-Min;Hwang, Seock-Yeon;Jeong, Min-Sik;Kim, Si-Kwan
    • Journal of Ginseng Research
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    • v.43 no.1
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    • pp.135-142
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    • 2019
  • Background: Panax ginseng Meyer, known as Korean Red Ginseng (KRG), is one of the important age-old traditional herbs used in boosting libido and improving male fertility. In this study, the effects of Rg3-enriched KRG extract (KGC04P) on heat stress-induced testicular damage in experimental rats was evaluated. Methods: Male rats (Sprague-Dawley) were divided into four groups (n = 10): normal control (NC), heat-stressed control (HC), heat-stressed plus KGC04P-100 mg/kg (HK100), and heat-stressed plus KGC04P-200 mg/kg (HK200) groups. Starting 1 week prior to heat stress, animals were administered orally with KGC04P (100 and 200 mg/kg) mixed with a regular pellet diet and continued for 25 weeks. Heat stress was induced to HC, HK100, and HK200 groups by intermittently exposing the animals to high temperatures ($32{\pm}1^{\circ}C$, 2 h/day). After 6 months, animals were euthanized under general anesthesia with carbon dioxide and evaluated for various parameters in serum and testicular tissue by using Western blotting, biochemical kits, and reverse transcription-polymerase chain reaction. Results: Significant (p < 0.05) alterations in several parameters, such as body/organ weight, sperm kinematics, and lipid metabolism marker levels, in the serum and testis of rats were observed. Further, the expression of testicular antioxidant enzymes, inflammatory cytokines, sex hormonal receptors, and spermatogenesis-related genes were also affected significantly (p < 0.05) in the heat-stressed group. However, KGC04P prevented the heat stress-induced changes in rats significantly (p < 0.05) at both concentrations. Conclusion: KGC04P attenuated heat stress-induced testicular damage by a multifunctional approach and can be developed as an excellent therapeutic agent for hyperthermia-mediated male infertility.

Survival of Neuro-Venous Flap without Perforator due to Accidental Division of Perforator (돌발적 손상에 의해 천공지가 없는 신경-정맥피판의 생존)

  • Byeon, Je Yeon;Choi, Hwan Jun
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.290-295
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    • 2018
  • Author planed peroneal artery perforator flap for ankle reconstruction and experienced successful result using sural neuro-lesser saphenous venous flap due to an unexpected event. A male Asian patient, 24 years old, had a history of recurrent operation wound disruption in the ankle region. Under general anesthesia, peroneal perforator and saphenous vein, as well as the sural nerve branches, were identified and preserved. In the process of flap rotation, an accidental division of peroneal artery perforator has occurred. Despite the division of the perforator, circulation was normal. The patient experienced no complication after the surgery. Some study reported that accompanying arteries and the vascular plexus around the sural nerve communicate. In conclusion, sufficient blood supply was possible only with the accompanying artery of the sural nerve without peroneal perforator. So, it is essential to always preserve not only perforator but also neurovascular bundles at any circumstances and any location.

Reduction of Isolated Zygomatic Arch Fractures with Gillies Approach (길리씨 접근법을 통한 협골궁 골절의 정복)

  • Shin, Dong Keun;Kim, Young Su;Shim, Woo Sub;Jung, Hahn Jin
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.11
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    • pp.588-592
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    • 2018
  • Background and Objectives The incidence of facial bone fracture is increasing. The zygomatic bone, due to its anatomical prominence, is the second most common site of all facial bone fractures. In this study, we present the clinical experiences of zygomatic arch fracture in a tertiary hospital and introduce the Gillies approach for reduction and its outcome results. Subjects and Method We collected data from retrospective chart reviews of patients who underwent surgeries from 2010 to 2017 for zygomatic arch fractures at Chungbuk National University Hospital. Data were analyzed according to age, gender, cause of trauma, location of trauma, and clinical symptoms including trismus. All surgery was performed under general anesthesia and via the use of Gillies approach. The result of surgery was evaluated by postoperative facial computed tomography. Results Sixteen patients underwent surgery for zygomatic arch fracture. The patients had the average age of 41.3 years, a male predominance of 15:1 and physical assault as the most common cause of trauma. The time lag between injury and surgical reduction was 5.5 days. The surgical outcomes were assessed 'good' in 14 cases and 'moderate' in one case. Patients who had trismus preoperatively were resolved of it in all cases after operation. Postoperative complications were absent. Conclusion The Gillies approach proved to be a relatively easy, safe, and reliable method, and its surgical outcomes was satisfactory in our experiences.

Usefulness of full-thickness skin grafting from the infraclavicular area for facial reconstruction

  • Kang, Jae Kyoung;Lee, Jae Seong;Yun, Byung Min;Shin, Myoung Soo
    • Archives of Craniofacial Surgery
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    • v.21 no.6
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    • pp.357-362
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    • 2020
  • Background: Full-thickness skin grafts (FTSGs) have been widely used after facial skin cancer resection, for correcting defects that are too wide to be reconstructed using a local flap or if structural deformation is expected. The preauricular, posterior auricular, supraclavicular, conchal bowl, nasolabial fold, and upper eyelid skin areas are known as the main donor sites for facial FTSG. Herein, we aimed to describe the effectiveness of using infraclavicular skin as the donor site for specific cases. Methods: We performed FTSG using the infraclavicular skin as the donor site in older Asian adults following skin cancer resection. Outcomes were observed for > 6 months postoperatively. The Manchester Scar Scale was used for an objective evaluation of satisfaction following surgery and scarring. Results: We analyzed the data of 17 patients. During follow-up, the donor and recipient sites of all patients healed without complications. Upon evaluation, the average Manchester Scar Scale scores for the recipient and donor sites were 7.4 points and 5.7 points, respectively. Conclusion: In general, conventional donor sites, such as the preauricular, posterior auricular, and supraclavicular sites, are widely used for facial FTSG because they achieve good cosmetic results. However, the infraclavicular skin may be a useful donor for facial FTSG in cases where the duration of time spent under anesthesia must be minimized due to a patient's advanced age or underlying health conditions, or when the recipient site is relatively thick area, such as the nose, forehead, or cheek.

Dacryocystectomy for Chronic Dacryocystitis in a Beagle Dog

  • Jeong, Youngseok;Lee, Songhui;Kim, Su An;Woo, Sangho;Ko, Dumin;Seo, Kangmoon;Kang, Seonmi
    • Journal of Veterinary Clinics
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    • v.38 no.3
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    • pp.152-158
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    • 2021
  • A 3-year-old spayed female beagle dog was presented with epiphora, severe hemorrhagic and purulent ocular discharge in the right eye (OD). A reflux of the discharge through the other canaliculi, associated with signs of chronic inflammation, was observed on cytology. Dacryocystorhinography revealed retention of contrast media ventral to the lower punctum, indicating complete obstruction and the potential presence of radiolucent foreign body. Ocular discharge subsided after the first treatment, including flushing of the nasolacrimal duct and application of topical antibiotics and corticosteroids, but clinical symptoms of the dacryocystitis waxed and waned thereafter. Surgical treatment was delayed for 8 months due to Dirofilaria immitis infection, and topical treatment and monthly flushing were maintained. On the day of operation, a foreign body was released through the fistula, while flushing for disinfection under general anesthesia, just before the surgery. Dacryocystectomy was performed to remove necrotic tissue and residual foreign body around the nasolacrimal cyst. Upon histopathologic findings, the removed foreign body was considered to be a plant, and the nasolacrimal cyst was comprised of chronic active ulcerative inflammation and necrotic tissues. At the 1-week recheck, improvement of epiphora and ocular discharge and healing of the surgical site was noted. In conclusion, nasolacrimal duct foreign body can be considered in recurrent dacryocystitis, despite nasolacrimal flushing and topical medication. In this study, dacryocystectomy was curative without recurrence of dacryocystitis or epiphora.

Modus Operandi: Irrigation of the Modified Eloesser Flap in Heterogeneous Suppurative Lung Pathologies

  • Vishnu, Rajkamal;Rai, Guruprasad D.;Kamath, Ganesh Sevagur;Kumara, Vijaya
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.137-142
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    • 2021
  • Background: Refractory empyemas with collapsed lung and persistent bronchopleural fistulas pose significant problems to thoracic surgeons and impose a substantial burden in terms of morbidity and mortality. The modified Eloesser flap procedure is a useful palliative option for clearing infections. Herein, we present our experiences with the modified Eloesser flap procedure in mixed suppurative lung pathologies with a new technique of irrigation for persistent infection. Methods: A retrospective review was carried out of 56 patients who underwent the modified Eloesser flap with continuous irrigation at Katurba Medical College. These patients had severe morbidities and were not suitable for major thoracic resection surgery, and electively underwent modified Eloesser flap surgery. Regular follow-up was done at 1, 3, 6, and 12 months. Patients with persistent infections were treated with our continuous irrigation technique. Results: The most important finding was that all patients with active sputum acid-fast bacilli-positive findings became sputum smear-negative during the first month of follow-up. Half (50%) of the patients had a patent stoma. Eleven patients had persistent infections, necessitating continuous irrigation. The infection was fully cleared after 1 month in 9 patients, while 2 patients required second irrigation and continued to receive follow-up. In the remaining 50% of the patients, the stoma closed completely, and the lung expanded fully. Conclusion: The modified Eloesser flap is a simple procedure. In suppurative pathologies, infections were well controlled and the general condition of the patients improved. Our continuous irrigation method showed promising results in patients with persistent purulent discharge.

Analysis for Risk Factors and Effect of Vocal Hygiene Education in Patients of Vocal Polyp (성대 용종의 예후 인자와 음성 위생법 치료 효과 분석)

  • Choi, Nayeon;Kim, Dong Gyu;Lee, GilJoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.1
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    • pp.24-28
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    • 2021
  • Background and Objectives Vocal polyp is one of the most common benign diseases of vocal fold caused by overuse of voice. Laryngeal microsurgery is the first treatment of choice for vocal polyp. However, surgery has many risks such as side effects of general anesthesia, injury of tooth and psychological burden. And we often experience reduction of vocal polyps without surgical procedure. The purpose of study is to evaluate the effect of non-surgical treatment such as vocal hygiene education and proton pump inhibitor (PPI) in patients with vocal polyp. Materials and Method We performed retrospective study for seventy-three patients of vocal polyp who treated with non-surgical modalities such as vocal hygiene education and PPI over three months. Treatment outcomes and risk factors such as age, sex, polyp size, position, symptom duration, presence of laryngopharyngeal reflux (LPR) symptoms, smoking history, voice abuse history and vocal hygiene education were evaluated by comparison between polyp size improved group and non-improved group. Results 5.5% of enrolled patients showed complete response and 23.3% showed partial response without surgery. Polyp size improved group significantly carried out more practice of vocal hygiene education treatment than the non-improved group (p=0.040). And the presence of LPR symptoms [hazard ratio (HR) 3.368, confidence interval (CI) 1.055-10.754, p=0.040] and not performing of vocal hygiene education (HR 3.664, 95% CI 1.078-12.468, p=0.038). Conclusion Vocal hygiene education can be a useful treatment option when making a decision to treat with vocal polyp.

Serial venous lactate measurement following gastrointestinal surgery in horses

  • Smanik, Lauren E.;Moser, Darla K.;Rothers, Kris P.;Hackett, Eileen S.
    • Journal of Veterinary Science
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    • v.23 no.5
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    • pp.66.1-66.8
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    • 2022
  • Background: Prospective clinical study of blood lactate concentration in horses undergoing colic surgery is needed to determine utility in outcome prediction. Objectives: To evaluate venous lactate measurements in horses following colic surgery, including immediately after anesthetic recovery and daily throughout hospitalization, as well as to determine if lactate concentrations were significantly higher in horses that developed postoperative complications or did not survive to hospital discharge. Methods: Horses > 1 year of age undergoing surgery for colic and recovered from general anesthesia were sampled. A portable lactate meter was used to measure venous samples collected immediately following anesthetic recovery and daily throughout hospitalization. Complications arising during hospitalization and survival to hospital discharge were recorded. Results: Fifty one horses were enrolled, ranging in age from 2 to 29 years. Lactate concentration immediately following anesthetic recovery was higher in horses that developed complications during hospitalization (p = 0.046). The odds of developing complications postoperatively were doubled for horses with a venous lactate concentration > 5 mmol/L. Lactate measurements in non-survivors were significantly higher compared to survivors by 96 h postoperatively (p < 0.006). Conclusions: Higher venous lactate concentrations in the postoperative colic period were associated with an increased risk of complications and death. Results suggest horses with higher venous lactate measurements in recovery are more likely to have postoperative complications, with the odds of developing complications doubled for horses with a venous lactate > 5 mmol/L. Evaluation of venous lactate could provide information on prognosis in the postoperative period for horses with surgical colic.

Giant Lipoma in the Lateral Neck Causing Internal Jugular Vein Deformity (내경정맥의 변형을 유발한 거대 경부 지방종)

  • Jun Ho, Choi;Sang Seong, Oh;Kwang Seog, Kim;Jae Ha, Hwang;Sam Yong, Lee
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.2
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    • pp.29-32
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    • 2022
  • Lipoma is one of the most common benign soft tissue tumors. However, giant lipomas compressing and deforming the neurovascular structure rarely occur in the lateral neck. A 70-year-old man visited our outpatient clinic for treatment of a visible painless neck mass that had been identified 2 years prior. Neck magnetic resonance imaging revealed that a 10 × 9 × 4 cm fatty mass located between the sternocleidomastoid and sternohyoid muscles invaded the carotid sheath. Under general anesthesia, the mass was excised without damage to the adjacent neurovascular structures. Upon histopathological examination, the mass was identified as a lipoma. During the surgery, enlargement of the internal jugular vein was observed under the resected mass. However, on ultrasound examination, the function of the internal jugular vein was evaluated as good. No recurrence or neurological and vascular complications were reported during a 6-month follow-up after the surgery. As a giant lipoma located in the deep layer of the lateral neck can deform important cervical structures, its impact on the surrounding structures should be carefully assessed preoperatively to minimize the rate of possible complications.