• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.408-412
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• 2010

Introduction: This study examined the depth of sedation and the usefulness of the monitoring tool in determining the level of sedation in patients undergoing third molars extraction under conscious sedation with midazolam. Materials and Methods: Twenty two patients undergoing third molars extraction at the department of Oral and Maxillofacial surgery, Ewha Womans Mokdong Hospital from February 2010 to April 2010 were analyzed. All patients were classified as American Society of Anesthesiologist (ASA) class I and had no contraindications tosedation. The bispectral index was recorded continually during surgery using a bispectral monitor. The initial sedation was accomplished using a 3 mg bolus of midazolam followed by a 2 mg bolus of midazolam until the level of sedation, at which the patient’s eyes were closed or the subject was responsive only to loud or repeated calling of their name, was reached. All subjects were surveyed with a postoperative questionnaire to evaluate the level of sedation. Results: The bispectral index (BIS) decreased approximately 5 minutes after midazolam administration, but increased at the local anesthesia injection and odontomy procedure. The amnestic effect was shown effectively in the early stages of surgery. Conclusion: Conscious sedation with intravenous midazolam is effective in achieving the effect of anxiolysis, analgesia and amnesia. The BIS is an objective and useful means of assessing the depth of sedation.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.240-245
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• 2010

Neurofibromatosis type 1, an autosomal dominant disorder with prevalence of 1 per 3000 people, has clinical features of cafe au lait spots in skin, multiple neurofibroma and dysplasia in skeletal, endocrinal, and blood vessel systems. Actual intraoral neurofibromas are known to occur in 25% of patients. A 9 year-old girl diagnosed with type 1 neurofibromatosis visited our hospital with chief complaint of gingival swelling. Gingival enlargement in lower anterior region existed and cafe au lait spots were confirmed in patient' skin. Enlarged gingival tissue were excised under local anesthesia. Neurofibroma was confirmed with biopsy. Clinical examination after months showed fine recovery without any evidence of recurrence. Due to its possibility of recurrence, periodic follow-up will be needed.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.39-42
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• 2015

Warthin's tumor is the second most common salivary gland benign tumor, typically occurring in the fifth to seventh decades of life which shows an indolent feature. It is usually found in the parotid gland but occasionally in extra-parotid locations such as peri-parotid lymph node. However, Report of solitary Warthin's tumor in cervical lymph node is unusual. We here report a case of 72-year-old male with simultaneous malignant melanoma on eyelid and cervical lymph node enlargement in cervical level II area thus mimicking malignancy metastasis. After excisional biopsy under the local anesthesia, pathology was reported as papillary cystadenoma lymphomatosum, which is a histologically pathognomic finding of Warthin's tumor. However, there was no suspicious tumorous lesion in major or minor salivary glands. This case suggests that Warthin's tumor should be considered as a possible pathology in solitary lymph node lesion of neck.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.321-324
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• 2008

Purpose: Lymphoma originated from mucosa associated lymphoid tissue(MALT) is most common in gastrointestinal system, and rarely found in salivary gland, thyroid, bronchus or orbit. We experienced a case of MALT lymphoma which was originated from conjunctiva and involving lower eyelid without metastasis. Methods: A 40-year-old man suffered palpable mass on right lower eyelid without pain. Orbital computed tomographic and ultrasonographic findings showed a conical mass($1.9{\times}1.2{\times}0.9cm$ size) inside lower eyelid. The mass was completely excised under local anesthesia and histopathological examination was followed. Results: Microscopic finding showed a multiple follicular colonization. In the follicle, small lymphocytes and plasma cells differentiated to centrocyte-like cell, monocyte B cell, plasma cell were diffusely infiltrated. Immunophenotyping was preformed on fixed section. The majority of the small cells were immunoreactive for the B cell marker CD20. Based on the typical histological findings supported by immunostaining, the mass was defined as MALT lymphoma. After excision, SPECT, abdominal CT was carried out and there were no evidence of extraorbital disease. Conclusion: Biopsy and pathological examination should be performed in patients who complain palpable mass on lower eyelid because of possibility of MALT lymphoma. Although MALT lymphoma is rarely metastasized, it is necessary to evaluate the extraorbital involvement using SPECT or other radiologic exams. For detecting extraorbital involvement, periodic follow-up examination is need.

• Parasites, Hosts and Diseases
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• v.55 no.6
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• pp.667-671
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• 2017

Ocular setariases of cattle were reported but those of equine hosts have never been reported in the Republic of Korea (Korea). We found motile worms in the aqueous humor of 15 horses (Equus spp.) from 12 localities in southern parts of Korea between January 2004 and November 2017. After the affected animals were properly restrained under sedation and local anesthesia, 10 ml disposable syringe with a 16-gauge needle was inserted into the anterior chamber of the affected eye to successfully remove the parasites. The male worm that was found in 7 of the cases showed a pair of lateral appendages near the posterior terminal end of the body. The papillar arrangement was 3 pairs of precloacal, a pair of adcloacal, and 3 pairs of postcloacal papillae, plus a central papilla just in front of the cloaca. The female worms found in the eyes of 8 horses were characterized by the tapering posterior terminal end of the body with a smooth knob. Worms were all identified as Setaria digitata (von Linstow, 1906) by the morphologic characteristics using light and electron microscopic observations. This is the first blindness cases of 15 horses infected with S. digitata (Nematoda: Filarioidea) in Korea.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.80-85
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• 2013

Twenty one cows in Goyang and Paju cities were referred due to displacement of the abomasum and foreign body in the rumen. Omentopexy and rumenotomy through a right flank celiotomy were performed for treatment of abomasal displacement and the foreign body removal in the rumen. The right paralumbar fossa is clipped and prepared surgically. Local anesthesia is instituted by performing inverted L block. The abdomen was entered through 25 to 30 cm vertical incision in the right paralumbar fossa starting 4 to 5 cm ventral to the transverse processes of the lumbar vertebrae. A 14-gauge needle with rubber tubing attached is inserted to relieve the gaseous pressure and to facilitate further exploration and manipulation. The rumen was gently pulled out of the abdominal cavity and incision was made at the omentum. Rumenotomy was done and retrieved the foreign body. After the rumen was rinsed with sterile saline, the rumen wall was closed by a Lembert suture technique. The omentum was closed by a simple continuous suture. Right flank omentopexy was performed for the surgical correction of abomasal displacement. Recovery results among 21 cows included 9 excellent, 5 good, 2 fair and 5 bad. It was considered that operation of abomasal displacement and foreign body removal in the rumen through right flank celiotomy was a good surgical technique to reduce expenses, surgical pain, and surgery time.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.178-181
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• 2010

Purpose: Retronychia is the embedding of the nail into proximal nail fold. Retronychia starts with disruption of the longitudinal growth of the nail. With the growth of a new nail, the old one is pushed upwards and backwards. This leads to embedding of the top nail into the ventral aspect of the proximal nail fold and results with chronic paronychia. We present a case of retronychia that was rarely reported in the literature. Methods: A 46-year old female presented with a 3-month history of painful right first, 2nd, 3rd toenail changes. Although she was initially treated with broad spectrum antibiotics, she did not response to therapy. Later, she presented to our department because of progressively worsening pain that impaired her walking. Physical examination revealed with proximal nail fold erythema, painful swelling, yellowish nail discoloration, and distal onycholysis. Bacterial and fungus culture showed no organism. Treatment was surgical nail avulsion under local anesthesia. Results: The postoperative course was uneventful. 10 months later, the patient had a normal growing nail and was free of symptoms. Conclusion: We report a case of retronychia on toenail. Retronychia is a proximal nail plate ingrowth into the proximal nail fold which is associated with multiple generations of nail plate misaligned beneath the proximal nail. Management consisted of simple avulsion of superimposed nail. Retronychia is suspected with a persistent paronychia, particularly in the setting of trauma. Avulsion of the top nail confirms the diagnosis and may be curative if the underlying nail appears healthy.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.236-240
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• 1997

The management of neonate with long gap atresia without a fistula(type A) is complex and controversial. Various esophageal reconstruction include use of native esophagus or replacement with colon, stomach and small bowel. A severe premature male, at 28 weeks gestation weighing 1.2kg, was born with type A esophageal atresia in Chonnam University Hospital. Initial treatment consisted of gastrostomy under the local anesthesia and suctioning of proximal pouch, and than underwent delayed esophageal end to end anastomosis. A minimal leakage and mediastinitis ocurred postoperatively, but was treated by adequate drainage and negative suction from the leakage site through the gastrostomy. The patient was discharged in good general condition and normal weight of 5.4kg after 4 months after the surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.516-525
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• 2004

Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate & rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before & after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.407-411
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• 1996

Stereotactic radiofrequency dorsal root ganglionotomy can be very useful procedures for the treatment of pain emanating from the lumbar segmental nerves. This procedure is reserved for patients who have failed conservative interventional treatments and in whom open surgical intervention is not an option. The advantages of the radiofrequency lesion method are presented, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The afferent fibers in the ventral root which are spared by dorsal rhizotomy but nerve fibers with their cells in the ganglion from either dorsal or ventral root can be destructed with stereotactic radiofrequency ganglionotomy. This technique is performed using a 100 mm cannula with a 5 mm active tip. Repeated lateral fluoroscopic view should be taken to make sure that cannlua still resides within the superior, dorsal quadrant or the foramen. With the cannula in this position, electrostimulation is performed and good paresthesia on the leg should be noted with 0.3 and 0.5 volt at 50 Hz stimulation. At 2Hz stimulation distinct dissociation between motor and sensory should be shown. Percutaneous lumbar ganglionotomy have carried out under local anesthesia on inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have been relieved of pain without serious complications.