• Archives of Plastic Surgery
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• v.41 no.1
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• pp.81-84
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• 2014

In this article, we present two cases of femoral pseudoaneurysm (PA) at the femoral arterial puncture site followed by necrotizing fasciitis, which is rare but can be fatal when not managed appropriately. PA was revealed by lower-extremity angiography and color-flow Doppler ultrasonography. Hematoma removal, thrombolysis, and bleeder ligation with Gelfoam were repeatedly performed by a vascular surgeon. When necrotizing fasciitis developed, aggressive surgical drainage and creation of a viable wound bed for reconstruction were mandatory. We adopted a vacuum-assisted closure device (Kinetics Concepts International) as the standard treatment for complicated, serious, infected PA of the puncture site. Excellent clinical outcomes were obtained.

• Journal of Korean Neurosurgical Society
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• v.47 no.1
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• pp.48-50
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• 2010

Spontaneous intracranial hypotension is often idiopathic. We report on a patient presenting with symptomatic intracranial hypotension and pain radiating to the right leg caused by a transdurallumbar disc herniation. Magnetic resonance (MR) imaging of the brain revealed classic signs of intracranial hypotension, and an additional spinal MR confirmed a lumbar transdural herniated disc as the cause. The patient was treated with a partial hemilaminectomy and discectomy. We were able to find the source of cerebrospinal fluid leak, and packed it with epidural glue and gelfoam. Postoperatively, the patient's headache and log radiating pain resolved and there-was no neurological deficit. Thus, in this case, lumbar disc herniation may have been a cause of spontaneous intracranial hypotension.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.16-21
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• 2007

Many kinds of materials have been used up to now for vocal fold paralysis. Although silastic block has been the most popular material, some difficulties in carving, positioning, and placing have been the causes to find more easily applicable materials. Hy-droxylapatite, gelfoam, hyaluronic acid and fat have been suggested and used for this purposes with some limitations. During last decade, Gore-Tex was introduced and replacing old materials and showed good surgical results with less difficulties. This material is biocompatible and familiar to surgeons because it had been invented in 1960's. In addition it is easy to shape and place Gore-Tex into the window with many clinical experiences. In some problem cases, it is easy to remove from the body with less damage to surrounding tissue. The basic surgical techniques are as follows. 1) Creating window. 2) Positioning and placing the material. 3) Immobilizing the material and closing the window. The modified methods ae introduced in details with figures.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.198-202
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• 2021

Super-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifocal, high-grade renal injuries. In such cases, surgical nephrectomy remains the more common treatment modality to ensure hemodynamic control. We present the unique case of a patient who presented in hemorrhagic shock following a major trauma that resulted in a grade 5 renal injury treated with complete renal artery embolization using Gelfoam, resulting in hemodynamic stabilization. Interestingly, imaging 1 month after embolization revealed residual enhancement of the inferior pole of the kidney, suggesting reconstitution of flow and partial renal salvage. Ultimately, transcatheter "nephrectomy" with careful selection of a temporary embolic agent may serve as a safe and efficient alternative to surgical nephrectomy with the added possibility of preserving partial renal perfusion and function in the emergent setting.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.53-64
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• 1999

Background : Massive and untreated hemoptysis is associated with a mortality of greater than 50 percent. Since the bleeding is from a bronchial arterial source in the vast majority of patients, embolization of the bronchial arteries(BAE) has become an accepted treatment in the management of massive hemoptysis because it achieves immediate control of bleeding in 75 to 90 percent of the patients. Methods: Between 1990 and 1996, we treated 146 patients with hemoptysis by bronchial artery embolization. Catheters(4, 5, or 7F) and gelfoam, ivalon, and/or microcoil were used for embolization. Results: Pulmonary tuberculosis and related disorders were the most common underlying disease of hemoptysis(72.6%). Immediate success rate to control bleeding within 24hours was 95%, and recurrence rate was 24.7%. The recurrence rate occured within 6 months after embolization was 63.9%. Initial angiographic findings such as bilaterality, systemic-pulmonary artery shunt, neovascularity, aneurysm were not statistically correlated with rebleeding tendency(P>0.05). Among Initial radiographic findings, only pleural lesions were significantly correlated with rebleeding tendency(P<0.05). At additional bronchial artery angiograpy done due to rebleeding, recanalization of previous embolized arteries were 63.9%, and the presence of new feeding arteries were 16.7%, and 19.4% of patients with rebleeding showed both The complications such as fever, chest pain, headache, nausea and vomiting, arrhythmia, paralylytic ileus, transient sensory loss (lower extremities), hypotension, urination difficulty were noticed at 40 patients(27.4%). Conclusion: We conclude that bronchial artery embolization is relatively safe method achieving immediate control of massive hemoptysis. At initial angiographic findings, we could not find any predictive factors for subsequent rebleeding. It may warrant further study whether patients with pleural disease have definetely increased rebleeding tendency.

• Clinical and Experimental Reproductive Medicine
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• v.28 no.3
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• pp.215-223
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• 2001

Objective: The purpose of this study was to make a guideline of uterine artery embolization for the treatment of uterine leiomyomas accompanying with adenomyosis in Korea. Materials and Methods : We performed the retrospective study for 37 women who had uterine leiomyomas accompanying with adenomyosis. Bilateral uterine artery embolization was performed in 37 patients (age range 25-65) during 17 months with pain, hypermenorrhea, urinary frequency etc due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. Results: All procedures were technically successful. Mean clinical follow-up was 12.8 months. Minor complication occurred in 82% patients after the procedure. After imaging follow-up (mean, 6.9 months postprocedure), median uterine volume decreased 34.4%, and dominant myoma volume decreased 86%. There was no statistical difference in uterine volume reduction and dominant myoma size reduction whether occluding agents was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, and gelfoam, and whether ultrasound measured Resistance Index value before the procedure was low or high. Conclusion: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas who no longer des ire fertility but wish to avoid surgery or are poor surgical risks. To our study, uterine volume reduction and dominant myoma size reduction in patients who had adenomyosis were similar to previous other studies in patients who had not adenomyosis. Therefore adenomyosis should not be considered as a contraindication for uterine artery embolization. Because there is little data about subsequent reproductive potential after this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted for occluding agents and Resistance Index.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.8 no.1
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• pp.15-21
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• 2012

Extraction of all nonrestorable teeth prior to bone marrow transplantation is the major dental management of the patient being prepared for the transplantation. But, there are four principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (3) Thrombocytopenic purpuras (4) Disorders of coagulation (liver disease, anticoagulation drug-heparin, coumarin, aspirin, plavix) If the hemorrhage from postextraction wound is unusually aggressive, the socket must be packed with local hemostatic agent and wound closure & pressure dressing are applied. But, in dental alveoli, local hemostatic agent (gelfoam, surgcel etc) may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by suture, pressure packing and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 57-years-old multiple disabled patient with anticoagulation drug.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.2
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• pp.87-91
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• 2004

Background and Objectives : Temporary vocal fold injection is not only performed to restore the laryngeal function in temporary unilateral vocal fold paralysis or paresis, but also performed as a test injection prior to the permanent injection. Gelfoam has been safely used for the past several decades for the temporary vocal fold augmentation. Recently, we found a new material, called Radieses Lite, may be used as a temporary injection material. Material and Methods : We report preliminary results of 11 patients who had Radiesse Lite injection with a variety of pathologies. Results : Based on the results from the 6 patients who completed follow-up, the duration of effectiveness of Radiesse Lite seems to be from 2 to 3 months depending on the injection amount. Radiesse Lite satisfies several requirements of the ideal temporary vocal fold injection material in terms of injectability, convenience, duration of effectiveness and safety. Conclusion : The authors concluded that Radiesse Lite might be a good option for temporary vocal fold injection especially in the office setting.

• Journal of Korean Neurosurgical Society
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• v.39 no.1
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• pp.11-15
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• 2006

Objective : A prospective, randomized, controlled clinical study is performed to verify the effectiveness of epidural dexamethasone-soaked gelatin sponges to reduce postoperative pain following lumbar microdiscectomy. Methods : Twenty-three patients (10 men and 13 women) undergoing lumbar microdiscectomy were included. Five pieces of gelatin sponge measuring $1{\times}1cm$ [Gelfoam; Pharmacia & Upjohn. Kalamazoo, MI, USA], soaked with either 5mg dexamethasone or an equal amount [2mL] of saline, were left on the decompressed nerve root after unilateral hemilami-nectomy, flavectomy and discectomy. Results : Subjective visual analog scale[VAS] scores of leg pain in the dexamethasone group on the first, third and first postoperative days [2.5, 2.5, 1.7, respectively] were significantly lower than in the control group [5.0, 4.8, 3.6][P<0.05]. No side effects related to the dexamethasone-soaked gelatin sponges were observed. Conclusion : The intraoperative application of dexamethasone-soaked gelatin sponges during lumber microdiscetomy can provide effective-postoperative analgesia without complications.

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.117-121
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• 2006

The surgical removal of solid deep-seated hemangioblastomas remains challenging, because treatment of these lesions is often complicated by severe bleeding associated with the rich vascularity of this tumor, and by severe neural tissue injury associated with the difficulty of en bloc resection, especially when the tumor is located at the cervicomedullary junction. Therefore, preoperative embolization of deep-seated solid hemangioblastomas may play an important role in successful surgical removal by reducing major bleeding and neural tissue damage. A 24-year-old woman, 28-weeks pregnant, was admitted to our hospital for the evaluation of quadriparesis, and brain magnetic resonance imaging[MRI] revealed intra-axial mass lesion in the cervicomedullary junction. After delivery, her neurologic symptoms became aggravated, and we decided to operate. Preoperative angiography revealed a hypervascular tumor in the posterior fossa, and embolization of the main feeding artery using gelfoam and microcoil, resulted in marked reduction of tumor vascularity. She underwent a midline suboccipital craniotomy involving the removal of the arch of C-1. The tumor was totally removed through a midline myelotomy, and at her 6-month follow-up she walked independently. We report on the combined use of the preoperative embolization of feeding vessels and subsequent operative resection in a patient with a solid hemangioblastoma at the cervicomedullary junction immediately after delivery.