• Journal of Trauma and Injury
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• 제27권3호
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• pp.89-93
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• 2014

Bile leaks are complications that are much more frequent after a high-grade liver injury than after a low-grade liver injury. In this report, we describe the management of bile leaks that were encountered after angiographic embolization in a 27-year-old man with a high-grade blunt liver injury. He had undergone an abdominal irrigation and drainage with a laparotomy on post-injury day (PID) 16 due to bile peritonitis and continuous bile leaks from percutaneous abdominal drainage. He required three percutaneous drainage procedures for a biloma and liver abscesses in hepatic segments 4, 5 and 8, as well as endoscopic retrograde cholangiopancreatography with biliary stent placement into the intrahepatic biloma via the common bile duct. We detected communication between the biloma and the bilateral intrahepatic duct by using a tubogram. Follow-up abdominal computed tomography on PID 47 showed partial thrombosis of the inferior vena cava at the suprahepatic level, and the patient received anticoagulation therapy with low molecular weight heparin and rivaroxaban. As symptomatic improvement was achieved by using conservative management, the percutaneous drains were removed and the patient was discharged on PID 82.

• 한방안이비인후피부과학회지
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• 제36권4호
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• pp.175-180
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• 2023

Objectives : The purpose of this study is to report a case of lipoma removed by surgical method. Methods : A 69-year-old female was diagnosed with lipoma on the left upper shoulder. Bufonis venenum pharmacopuncture was used for local anesthesia. The 11th blade and the CO₂ laser was used for incision. After removal of lipoma, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were carried out. For 7 days, Yeonkyopaedok-san was given and the suture was removed after 14 days. At last, saengkigo was applied. Results : Local anesthesia was maintained. Lipoma sized 3.0×1.0×1.0cm was clearly removed. Adverse effects were not reported until the clear skin adhesion. Conclusions : Lipoma were surgically removed without any complications by using pharmacopuncture and oral herbal medicines that have anti-inflammatory effects. Korean medicine has the potential for surgery and needs to extend the range of surgical treatment.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.136-139
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• 2007

견관절경 수술로 많은 질환을 치료할 수 있으며 개방 술식에 비하여 많은 장점을 가지고 있다. 드물게 견관절 수술 후 세척액이 관절외 연부조직으로 유출되어 목과 인두에 부종을 유발하는 기도합병증이 보고되고 있다. 이 논문은 관절경하 회전근 개 봉합 수술 후 치명적으로 발생했던 기도 폐쇄를 보고하고자 한다. 결론적으로 이러한 위험한 합병증을 예방하기 위해서는 마취된 환자의 경우 불편감을 호소할 수 없으므로 술자들의 경부 부종 상태를 주기적으로 점검하여야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제29권6호
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• pp.738-743
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• 2000

Objectives : The less invasive stereotactic surgery of hypertensive intracerebral hematoma has been preferred. Many techniques were developed to facilitate aspiration of a dense blood clot in acute stage. Authors describe a method for evacuation of putaminal hematoma via computerized tomography(CT)-aided free-hand stereotactic infusion of urokinase and frequent negative pressure aspiration. Patients and Methods : A total of ten patients with spontaneous putaminal hematoma underwent surgery with negative pressure aspiration in the three-year period. All procedures were performed within 12 hours of insult. A silicone ventricular catheter was inserted into the center of hematoma through a burr hole at the Kocher's point under local anesthesia. In a typical case of putaminal hematoma, the trajectory of catheter was pointed the center of hematoma parallel to sagittal plane vertically and the external auditory meatus posteriorly. Immediately after the first trial of hematoma aspiration low-dose urokinase solution(2,000IU/5ml saline) was administrated through the catheter and drain was clipped for 30 minutes. Subsequently, the partially liquified hematoma was manually aspirated using a 10ml syringe with a negative pressure of less than 2 to 3ml. The procedure was carefully repeated every 1 hour until the hematoma was near totally evacuated. Results : The patients population consisted composed of 4 men and 6 women with a mean age of 61.6 years. All had major neurological deficits preoperatively. The mean hematoma volume was 44.3 ml and hematoma was drained for 20 to 48 hours. No complications such as rebleeding, meningitis, or malplaced catheter were noted. Outcome was moderately disabled in four patients and good recovery in three patients. Conclusion : Although the frequent negative pressure aspiration and low-dose urokinase infusion has the disadvantage of possbility of rebleeding and infection, it is consisdered to be an effective method because it allows a simple, safe, and complete removal of hematoma.

• 대한소아치과학회지
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• 제40권3호
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• pp.216-222
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• 2013

감염된 미성숙 영구치의 치수치료에 있어 줄기세포의 분화를 유도하는 생활조직의 재생과 지속적인 치근형성을 도모하는 방향으로 패러다임이 전환되고 있는데, 여기에서는 소독, 스캐폴드(scaffold), 그리고 폐쇄가 중요하다. 소독을 위해 triple antibiotics가 널리 사용되고 있으며, 스캐폴드로써 기존의 혈병대신 platelet-rich fibrin의 사용이 보고되었다. 본 증례보고에서는 치외치 파절에 의해 치수가 감염된 미성숙 영구치에서 platelet-rich fibrin을 스캐폴드로써 이용한 치수 재혈관화를 시행하였다. 발수와 근관세척 후 첫 증례에서 국소적 항생제의 적용 없이 platelet-rich fibrin을 단독 사용하였고 두 번째와 세 번째 증례에서는 국소적 항생제 적용 후 platelet-rich fibrin을 적용하였는데 모두 양호한 치유 결과를 얻었다.

• Archives of Plastic Surgery
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• 제40권3호
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• pp.251-255
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• 2013

We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권1호
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• pp.21-28
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• 2019

Objectives: Osteoradionecrosis (ORN) is one of the most severe complications resulting from radiotherapy (RT) in patients with head and neck cancer (HNC). It is characterized by persistent exposed and devitalized bone without proper healing for greater than 6 months after a high dose of radiation in the area. To describe the profile and dental management of ORN in HNC patients undergoing RT in an oncological clinical research center. Materials and Methods: A retrospective descriptive study was performed to analyze dental records from HNC patients with ORN treated at an oncological clinical research center from 2013 to 2017. A total of 158 dental records for HNC patients were selected from a total of 583 records. Afterwards, this number was distributed to three examiners for manual assessments. Each examiner was responsible for selecting dental records that contained an ORN description, resulting in 20 dental records. Results: Mean patient age was 60.3 years with males being the most affected sex (80.0%). The most affected area was the posterior region of the mandible (60.0%) followed by the anterior region of the mandible (20.0%) and the posterior region of the maxilla (10.0%). The factors most associated with ORN were dental conditions (70.0%) followed by isolated systemic factors (10.0%) and tumor resection (5.0%). There was total exposed bone closure in 50.0% of cases. The predominant treatment was curettage associated with chlorhexidine 0.12% irrigation (36.0%). Conclusion: Poor dental conditions were related to ORN occurrence. ORN management through less invasive therapies was effective for the closure of exposed bone areas and avoidance of infection.

• 한방안이비인후피부과학회지
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• 제36권4호
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• pp.181-186
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• 2023

Objectives : The purpose of this study is to report case of hypergranulation tissue that occurred after laparotomy and dissected by CO₂ laser. Methods : A 72-year-old female had hypergranulation tissue on the epigastrium. Local anesthesia was achieved with bufonis venenum pharmacopuncture. The CO₂ laser was used for dissection. After removal of granulation, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were performed. Yeonkyopaedok-san were administered for 7 days and the suture was removed after 14 days. At last, saengkigo was applied. Results : Hypergranulation tissue sized 1.0×1.0×1.0cm was clearly removed. Including excessive growing of granulation tissue, adverse effects were not reported until the clear skin adhesion. Conclusions : Hypergranulation tissue was surgically removed and sutured completely without any complications by using pharmacopuncture, oral herbal medicine and ointment that have anti-inflammatory effects and wound healing. Through this study, it is hoped that surgery including suture will be actively performed in more diverse diseases in the Korean medicine community.

• Journal of Chest Surgery
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• 제37권2호
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• pp.160-165
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• 2004

다방성 흉막수 또는 농흉 환자의 성공적인 치료를 위해서는 효과적인 배액술과 원인적 질환의 확진이 필요하다. 본 연구의 목적은 폐쇄성 흉강 삽관술 등의 치료에도 배액되지 않은 농흉이나 다방성 흉막수 환자에서 비디오 흉강경을 이용한 배액술 및 데브리망, 세척술의 효과와 실효성의 평가를 목적으로 한다. 대상 및 방법: 2000년 4월부터 2002년 7월까지 본원 흉부외과에 흉막수 및 농흉으로 입원한 환자 중 폐쇄성 흉강 삽관술 등으로 적절히 배액되지 않았던 환자 중 발병한지 2주일이 안된 20명을 대상으로 수술 전 흉부 전산화 단층 촬영을 실시하여 환자의 상태를 평가한 후 전신 마취하에서 비디오 흉강경을 이용한 배액술 및 데브리망, 조직검사, 세척술을 실시하였다. 결과: 20예의 환자 중 18예에서 성공적인 비디오 흉강경 배액 및 세척술이 실시되었고 2예에서 개흉술을 시행하였다. 남녀 비는 4 : 1이었으며 평균 연령은 48.9세(17∼72세), 수술 후 평균 흉관 거치 기간은 8.2일(4∼22일), 수술 후 평균 재원 기간은 15.2일(7∼33일)이었다. 원인 질환으로 결핵, 폐렴에 의한 합병증, 외상에 의한 혈흉, 전이성 유방암 등이었다. 수술 후 중대한 합병증은 없었으며 환자들은 증상이 호전되어 외래 통원 치료 및 추적 관찰 중이다. 결론: 기질화 되지 않은 초기의 농흉이나 다방성 흉막수 환자에서 비디오 흉강경을 이용한 배액술, 데브리망은 비교적 안전하고 유용한 시술이라 하겠다.

• Restorative Dentistry and Endodontics
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• 제23권2호
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• pp.656-669
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• 1998

Hydrogen peroxide at high concentration during walking bleaching may cause damage to the tooth structure and to the surrounding periodontal tissues and may develop external root resorption. Clinically, It is so important to find a method of prevention or minimization of these complications. The efficacy of various chamber-irrigating agents to eliminate residual hydrogen peroxide after walking bleaching was examined and compared with water rinse in this study. Extracted human 46 premolars without any cementoenamel junction defects were treated endodontically and based with IRM to 1 mm below CEJ and totally bleached 3 times for each tooth with 30% hydrogen peroxide and sodium perborate. Upon completion of the 3rd walking bleaching procedure, the cervical portion and pulp chamber of each group of teeth were irrigated with catalase, 70% ethylalcohol, acetone, and distilled water. And then, a radicular hydrogen peroxide penetration was measured with spectrophotometer immediately after each bleaching and following treatment with each chamber-irrigating agents, and the significance of their eliminating efficacy of residual hydrogen peroxide was analyzed by Kruskal-Wallis test. The results were obtained as follows. 1. Cervical root penetration of hydrogen peroxide was increased as the bleaching procedure was repeated(P<.01). 2. The most effective irrigant that removed residual hydrogen peroxide was the catalase, and the least effective one was water rinsing (P<.01).; there was no significant difference between the acetone and ethanol group. 3. The Irrigation with antioxidant enzyme or water-displacement solutions can eliminate residual oxygen radicals from the pulp chamber effectively after walking bleaching. So, these agents can reduce adverse effects such as cervical external resorption and periapical inflammation and prevent residual $O_2$ from impeding composite resin polymerization, thus increase the bonding strength of composite resin. This, in turn reduces microleakage and discoloration of the esthetic restoration, extending its service-life.