• Journal of Korean Neurosurgical Society
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• 제30권10호
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• pp.1241-1244
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• 2001

The authors report a very rare case of tuberculous spondylitis combined with a schwannoma of spinal cord. A 39- year-old man was admitted because of paraparesis(G1/G2). MRI showed severe cord compression at two different levels. One was by the bulged soft tissue and subligamentous abscess extending from T7 to T9 and the other was by an intradural extramedullary cord tumor at the level of T1-2. At first operation, T8 corpectomy and T7-9 plate fixation with autogenous iliac bone graft were performed. After then, Paraparesis was improved(G2/G3) postoperatively. The second operation underwent two weeks later. The tumor was totally removed and shortly after second operation, paraparesis was markedly improved(G3/G4). Histological diagnosis were tuberculous spondylitis and schwannoma, respectively. The authors reviewed this case where good surgical outcome was obtained by two stage operation.

• Journal of Oral Medicine and Pain
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• 제48권3호
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• pp.81-86
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• 2023

Purpose: To evaluate the clinical and radiologic findings of the postoperative maxillary cysts (POMCs) and investigate the relationship between lesion size and clinical symptoms depending on the time elapsed after radical maxillary sinus surgery. Methods: A total of 29 patients who were diagnosed with POMCs at Chonnam National University Dental Hospital were selected. Clinical and radiologic findings were investigated. POMC cases were divided into two groups: those with <24 years between maxillary sinus surgery and POMC diagnosis and those with >24 years. The chi-square test was used to compare the differences between the two groups. Results: The average period from surgery to POMC detection was 24.32 years; however, the period could not be confirmed in four patients. The average patient age was 52.75 years, and 12 (41.3%) patients were in their 50s. POMC-related clinical symptoms were as follows: buccal pain and swelling, dull pain, toothache, abscess, sensory abnormality, and asymptomatic. Twenty (69.0%) cases showed unilocular radiolucency and 9 (31.0%) revealed multilocular radiolucency. Seven cases (35.0%) were misdiagnosed as odontogenic lesions, resulting in the delayed treatment of POMCs. No statistical significance was found between the two groups with respect to symptoms, expansion to the surrounding area, presence of secondary cysts, and mesiodistal length of cyst on cone-beam computed tomography (CBCT) images. However, the buccopalatal length of the cyst on CBCT images was significantly different between the two groups. Conclusions: The buccopalatal length of POMCs observed on CBCT images was related to the time elapsed since surgery. The lack of awareness of POMCs may lead to misdiagnosis as an odontogenic infection and delayed treatment. Therefore, dentists must recognize the clinical and radiologic features of POMCs to differentiate it from dental infections.

• Investigative Magnetic Resonance Imaging
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• 제17권1호
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• pp.59-62
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• 2013

이물질에 의한 주변조직의 반응성 변화는 염증, 부종, 액체저류, 혈종, 감염, 농양, 육아종 등의 다양한 형태를 보이며, 이물질의 종류와 시간 경과에 따라 다양한 영상소견을 보이기 때문에 연부조직 종양 등과 쉽게 혼동 할 수 있다. 자기공명 영상은 이물질의 방사선 투과성이나 음향 임피던스와 관계없이 진단할 수 있으며, 특히 주변조직의 변화를 잘 보여준다. 이에 저자들은 알약 분쇄물을 식염수와 섞어 전완에 주사한 후 발생한 종창으로 내원한 26세 여자의 자기공명 영상에서 무수히 많은 미세한 신호 강도 소실 물질과 주변의 액체저류 및 T1 저신호, T2 고신호 강도의 비균질성 조영증강 병변을 확인하였다. 이는 수술을 시행하여 흡수되지 않은 알약 분쇄물 및 주변의 액체저류와 염증반응으로 확인되었기에 이를 자기공명 영상소견과 함께 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제60권1호
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• pp.114-117
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• 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.

• 임상이비인후과
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• 제29권2호
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• pp.223-228
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• 2018

Background and Objectives : Necortizing fasciitis in the cervical region is a very rare disease with high mortality and morbidity rates. The purpose of this study was to analyze the clinical characteristics, treatment results, complication and prognosis of necrotizing fasciitis patients. Materials and Methods : We retrospectively reviewed the inpatient charts treated for cervical necrotizing fasciitis at our Otorhinolaryngology clinic. We diagnosed necrotizing fasciitis by the clinical findings such as swelling, redness and pain of infected area and necrosis of subcutaneous fat layer and fascia observed during surgery. Twenty such patients were identified and treated from January 2011 to December 2016. Results : 20 adults consisting of 14 male and 6 females with cervical necrotizing fasciitis were diagnosed and treated. The most commonly known associated preceding illness were dental abscess and tonsillitis. The most pathogen was Streptococcus species (12/20), followed by Klebsiella pneumonia (6/20), Staphylococcus species (2/20). The mean duration of hospitalization was 32.2 days (range,14-86). The mean Modified Laboroatory Risk Indicator for Necrotizing Fasciitis (M-LRINEC) score is 7.4 and more than 4 points was eighteen. All patients received parenteral antibiotics and surgical drainage after admission. Conclusions : The reason for the high survival rate in the study was the early diagnosis, as well as the early surgical procedure and antibiotics. After the operation, frequent betadine irrigation could improve the patient's condition and recover without severe complication.

• Annals of Coloproctology
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• 제34권6호
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• pp.317-321
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• 2018

Purpose: We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL). Methods: Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL. Results: Two hundred thirteen consecutive patients, 122 males and 91 females, were included. The mean age was $66.91{\pm}11.15years$, and the median body mass index was $24kg/m^2$ (range, $20-35kg/m^2$). The median tumor distance from the anal verge was 8 cm (range, 4-12 cm). Ninety-three patients (44%) received neoadjuvant therapy for nodal disease and/or locally advanced rectal cancer. Only 13 patients (6%) developed AL. Six patients developed subclinical AL as they had a defunctioning ileostomy at the time of the initial procedure. They were treated conservatively with TD under endoscopic guidance in the endoscopy unit and received intravenous antibiotics. Six weeks after discharge, these 6 patients underwent follow-up flexible sigmoidoscopy which showed a completely healed anastomotic defect with no residual stenosis. Seven patients developed a clinically significant AL and required reoperation with pelvic abscess drainage and Hartmann colostomy formation. Conclusion: These results suggest that TD for management of patients with AL is safe, cheap, and effective. Salvaging the anastomosis will help decrease the need for Hartmann colostomy formation. Proper patient selection is important.

• 한국임상수의학회지
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• 제32권3호
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• pp.275-277
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• 2015

안면부 부종으로 내원한 1년령의 암컷 슬로우로리스의 신체검사에서 좌측 상악 견치의 골절이 확인되었다. 세포검사 및 방사선상에서 세균감염과 치수염이 각각 확인되었다. 세균은 배양 및 분자진단을 통해 Streptococcus gordonii로 동정되었다. 손상된 치아의 발치 및 항생제 투여 후 병변은 소실되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.62-67
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• 2010

The spreading pathways which is the cause of infection on head and neck area are submandibular space, masticatory space, parapharyngeal space, retropharyngeal space, carotid sheath and mediastinum, etc. If spread to parapharyngeal area involving airway, such infection can be life-threatening by airway obstruction, or can cause vascular injury followed by hemorrhage, nerve injuries. Also, if spread to superficially, necrotizing fasciitis and many complications may occur including gangrene of skin. The key to successful treatment of infection on head and neck area is recognition of spreading pathways, early diagnosis and following therapeutic management. Our department present two cases, one is infection progressed superficially to suprasternal space, another is spreading deep according to parapharyngeal space, subclavian space and carotid sheath followed by airway obstruction, and obtained significant results with surgical incision and drainage, administration of selected antibiotics, continuous post-operative treatment. We report these 2 cases with literatures review.

• Journal of Chest Surgery
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• 제30권11호
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• pp.1117-1120
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• 1997

충남대학교병원에서 1980년7월부터 1995년 8월까지 경험한 식도이물 10례를 수술 치료하였다. 나이는 25 세에서 71세로, 평균 나이는 45.3세였고 남녀의 비는 6:4였다 가장 흔한 증상은 연하곤란, 발열, 이물감, 경부 동통이였다. 이물질은 생선뼈 3례였고, 거품 약포장지가 2례였고, 맥주병 마개,욕조 물마개, 깨진 사발 조각, 닭고기, 콩이 각각 1례였다. 진단은 수용성 식도 조영제와 식도 내시경을 이용하였다. 10례중 2례에서는 과거에 가성소다 섭취로 인해 식도 협착이 있었다. 1례에서는 정신과적 문제가 있었다. 식도이물은 모두 수술적 처치로 제거하였다 5례에서는 경부식도절게술을 시행하였고 1례는 우측 개흉술 을, 1례는 개복하여 위를 통해 위관을 역류성으로 통과 제거하였으며, 2례는 경부농양이 있어 절개후 배농하 였다. 3례는 수술 후 누출이 있었으나 수술치료없이 보존적 요법으로 호전되었으며,1례는 일시적인 애성이 있 었다. 1례는 외상성 기흉이 발생하여 폐쇄적 홉관 삽관술로 치료하였다. 수술 사망자는 없었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권6호
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• pp.669-676
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• 2007

본 교실에서는 당뇨와 지방간의 전신 질환이 있는 환자에서 구강 내 외상으로 안검의 안와 격막을 통한 안와 연조직염, 상악 제1대구치 치근단 농양이 측두와를 통한 안와 외측 골막하 농양, 상악 제2유구치 치료 후 상악동염 및 사골미로염을 통한 안와 내측 골막하 농양, 하악 제1대구치 치근단 농양이 저작간극과 측두와를 거쳐 관골의 안와부 골수염 및 안와 외측 하방에 골막하 농양, 상악 제2,3대구치 치근단 농양이 익돌구개와, 측두하와 및 하안와열을 거쳐 안구 후방에 안와농양을 형성한 후 기존의 농양 전상방부에 새로운 농양을 형성하며 상안와열증후군으로 까지 진행된 증례를 비롯하여 다양한 안와연조직 감염의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.