• Journal of Chest Surgery
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• 제24권1호
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• pp.54-63
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• 1991

Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

• 대한영상의학회지
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• 제85권2호
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• pp.463-467
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• 2024

침술은 아시아 문화권에서 빈번하게 시행되고 있으며 비교적 안전한 시술로 알려져 있다. 그러나 침술과 관련된 부작용은 지속적으로 보고되고 있다. 따라서, 의료진은 침술과 관련된 합병증의 가능성을 인식하고, 심각한 경우에는 적극적으로 치료해야 한다. 우리는 침술로 인해 발생한 후복막강과 대퇴부 근육의 큰 농양과 이를 경피적 카테터 배액술 및 수술적 절개와 배농술로 치료한 사례를 보고한다.

• 자원환경지질
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• 제44권5호
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• pp.399-412
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• 2011

지형정보가 전산화됨으로서 수치표고모델 및 위성영상사진 등이 지질조사에 활용되고 있다. 이 연구에서는 남대천 유역의 하천 수계 천이점을 추출하여 단층운동과의 연관성을 규명하고자 하였다. 경상북도 울진군에 위치하고 있는 남대천 유역은 S1, S2, S3 등 세 개의 소유역으로 구분되며, 수치표고모델로 추출된 천이점들은 거의 모두 소유역의 중류 및 중상류에 분포하고 있다. S1 구역에서는 하각률과 관련 있는 지형경사도 Ks와 하천 수계의 요형도 값이 S2 나 S3 보다 높은 값을 보이고 있다. 이는 삭박작용이 활발하여 하각률이 높은 것에 기인되는 것으로 암상 차에 의한 것보다는 다수의 단층에 의한 것으로 해석된다. 하위지류를 포함한 남대천 유역의 천이점은 모두 77개이며, 이 중 주요 수계 S1, S2, S3에 발달하고 있는 천이점은 24개소이다. 77개소 중 이중 단층과 일치하고 있는 천이점은 27개소 (38%)이며, 주요 수계 상에서 단층과 일치되는 천이점은 13개 지점 (54%)이다. 그러므로 주요 수계와 단층과는 밀접한 관계가 있음을 알 수 있다. 즉, 조사지역의 상대 경사도 값 Ks의 평균은 38.8이다. 그러나 두천단층과 삼당단층이 중첩되는 부분에서는 해발고도를 고려하더라고, 상대적 경사도 $K_s$은 42.99~43.39로 다른 전이점보다 매우 높은 값을 보이므로, 천이점 형성은 단층과 유관한 지형변위임을 지시한다. 또한 천이점의 분포와 지질 경계부를 비교해볼 때, 천이점은 암상 경계부와도 무관하게 발달하고 있으나, 단층분포와 연관성이 있음을 알 수 있다. 결론적으로, 수계의 천 이점 발달은 단층 운동에 의하여 형성될 수 있는 지형변위로 판단된다. 수계 분석을 통해 천이점이 단층에 의한 지형 변위로 볼 수 있으며, 제 4기 단층을 규명하거나 단층 연장을 규명할 수 있는 수단으로 활용 될 수 있다.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.799-802
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• 2007

Purpose: The masserteric space is an important tissue compartment of the face, but a disease in it is difficult to diagnose and treat. The submasseteric abscess is located between the masseter muscle and mandibular ramus with different appearances such as sepsis, infection, or tumor. Especially the common misdiagnosis of submasseteric abscess is acute or chronic parotitis. The purpose of this report is to pay special attention to the possible diagnosis of submasseteric abscess for the symptoms of unilateral cheek swelling and tenderness that accompany marked trismus. Methods: A 11-year-old boy came to our hospital because of facial swelling, tenderness, and trismus in a history of left cheek swelling and toothache. We diagnosed his case as submasseteric abscess by CT scan and surgical intervention was performed. Under general anesthesia, the abscess was opened by the intraoral incision and considerably massive pus was drained. Results: Swelling, tenderness, and trismus became to subside during postoperative 10 days and general condition and vital signs became stable. After 6 months, CT scan showed that both masseteric muscles were symmetric and there was no periosteal reaction of the mandible. Conclusion: In conclusion, submasseteric abscess is a rare infection with the symptoms of cheek tenderness and marked trismus. A detailed medical history and clinical examination of a patient as well as computed tomography(CT) are important tools in the accurate diagnosis and efficient treatment of the submasseteric abscess. Adequate drainage, removal of cause, and antibiotic infusion are the management of choice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.351-355
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• 2017

Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권5호
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• pp.331-336
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• 2013

Maxillary sinus membrane elevation and bone graft have been performed routinely in alveolar bone with insufficient residual bone height. There are a number of causes for development of maxillary sinusitis after these procedures. When maxillary sinusitis is caused by sinus membrane elevation, bone graft, and implant placement, various treatment such as medication, incision and drainage (I&D), implant removal, and the Caldwell-Luc procedure can be considered. Removal of an implant or the Caldwell-Luc procedure can be harmful if inflammation is not present in the oral cavity and survival of grafted bone and implant osseointegration can be expected despite the presence of maxillary sinusitis. In this case, functional endoscopic sinus surgery, which was often used in the otorhinolaryngology department, was performed without removal of the implant for a patient with maxillary sinusitis after one month following implant placement. Thus, we report on this case with a review of the literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권6호
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• pp.570-575
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• 2001

This study evaluated the short-term outcome of treating fractures of the mandible with bioabsorbable plates. Thirty-four fractures of the mandible in 27 patients were treated by open reduction and internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm, and 1.5-mm pre-tapped screws. The duration of intermaxillary fixation ranged from 0 to 23 days, with a mean of 5.3 days. Patients were evaluated for complications during the follow-up period, which ranged from 2 to 18 months. Five patients(18.5%) experienced complications. These included infection (four patients), and premature occlusal contact(one patient). Except for one case, all complications were minor and adequately managed with incision and drainage, elastic traction, and medication. Delayed infection (osteomyelitis) developed in a symphysis fracture and was treated by saucerization and antibiotics. The fracture line subsequently showed complete consolidation. Bioabsorbable plates can be selectively used for internal fixation in mandibular fractures with the advantage that they do not need to be removed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권4호
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• pp.199-203
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• 2014

Clear cell odontogenic carcinoma (CCOC) is a rare jaw tumor that was classified as a malignant tumor of odontogenic origin in 2005 by the World Health Organization because of its aggressive and destructive growth capacity and metastasis to the lungs and lymph nodes. We report a case of a 66-year-old female who had swelling, incision and drainage history and a well-defined unicystic radiolucent lesion that was comparable to a cystic lesion. At first, the patient received decompression, and the lesion size decreased. Three months after decompression, cyst enucleation was performed. The pathologic result indicated that the lesion was CCOC. In this report we emphasize that patients with painful cystic lesions in addition to jaw enlargement and loosening teeth should be considered for the possibility of malignancy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.510-514
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• 2011

An intracapsular and pericapsular infection of the temporomandibular joint (TMJ) is rare. The invasion of bacteria into the joint space can occur through several routes. Among them, hematogenous spread is most common. This report describes three cases of abscess formation in the TMJ (intracapsular and pericapsular infection). The patients were treated with supportive care and surgical intervention (incision and drainage) under hospitalization, and their symptoms had improved. Pain of the TMJ is a typical symptom of temporomandibular joint disorders (TMD). On the other hand, an infection of the TMJ can also cause pain on the affected side, and can be misdiagnosed as routine TMD. Therefore, the possibility of an infection of the TMJ cavity should be considered when treating TMD.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권1호
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• pp.110-116
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• 2000

A 61-years old man with diabetes mellitus(DM) was admitted to our hospital, complaining of progressive right periorbital swelling, headache and toothache on the right lower second molar. On the first visit, moderate swelling was noticed from the right periorbital region with exophthalmos and subconjunctival effusion. Intraorally, right lower second molar had a severe periodontal disease and fistular formation on its distal area. From 3 days after hospitalization, the visual acuity of his right eye was gradually worsen and we performed CT scan. CT scan demonstrated an inflammatory change at the right orbit with subperiosteal abscess at the inferior orbital wall, which was extended from the right infratemporal, parapharyngeal and internal pterygoid space. Patient was treated by mean of intraoral(right upper vestibular and retromolar) and extraoral(infraorbital) incision and drainage, massive anti-therapy and DM control. The patient improved gradually and finally was discharged from the hospital, but his visual loss of right side was not recovered.