• Archives of Plastic Surgery
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• v.34 no.4
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• pp.508-511
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• 2007

Purpose: Dermoid cysts are almost always caused by congenital events. The most widely accepted pathogenesis is that the cysts are dysembryogenetic lesions that arise from ectodermic elements entrapped during the midline fusion. We report a rare case of dermoid cyst, which occurred not congenitally but newly in the subcutaneous scar tissue secondary to trauma. Methods: A 26-year-old man had a deep submental laceration caused by a car accident and got a primary wound closure 16 months ago. There were 18 cm-long submental hypertrophic scar and newly developed palpable masses inside the subcutaneous layer at the center of the scar. Initial impression was an epidermal cyst or a thyroglossal duct cyst. Ultrasonographic finding showed two cystic masses inside the scars at the submental area, but impressed dermoid cysts. The cystic masses were completely removed with W-plasty and histological examination were followed. Results: The histological diagnosis was dermoid cysts which were mainly composed of keratotic squamous epithelium in their inner surface linings and numerous skin appendages such as sebaceous glands, sweat glands, and hair follicles in their cystic lumens histopathologically. During the follow-up period of 25 months, there was no recurrence of any subcutaneous mass in the site of scar. Conclusion: We report a very unusual case of dermoid cysts developed by an acquired cause, considering that the accidental inclusion of deep skin elements caused by a trauma can be a critical origin of dermoid cysts.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.667-669
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• 2009

Purpose: Radial and ulnar arteries are two major arteries responsible for the blood supply of the hand. We experienced early recurrent thrombosis of ulnar artery after arteriorrhaphy in a patient with rupture of ulnar and radial arteries due to glass injury. Thus, we thought this would require reviews. Method: 41 - year - old female patient was presented for the laceration of right wrist due to glass injury. Operative findings revealed the rupture of radial artery, ulnar artery, ulnar nerve and most of the flexor tendons. We performed three consecutive operations because of the recurrent arterial thrombosis in ulnar artery. Arteriorrhaphy was performed in each operation and the interpositional vein graft was performed in the final operation. Result: Consequently, doppler ultrasonography was performed on twentieth postoperative day and fair flow in the ulnar artery was visualized. Pathologic examination of the artery revealed no histopathologic abnormalities. Conclusion: It is not a matter of ease to follow up the patients with rupture of radial or ulnar arteries. Obstruction of the repaired artery is also not easy to detect because it usually presents no definite symptoms. We could detect the obstruction of the artery following arteriorrhaphy with the doppler ultrasonography in less than a week postoperatively, and repeated operations were followed. We reviewed the causes and factors affecting the thrombosis and hereby report with literature review.

• Journal of Veterinary Clinics
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• v.10 no.1
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• pp.141-145
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• 1993

The present study was performed in order to clarify the significance of serum amyloid A(SAA) estimation for the diagnosis of bovine amyloidosis and SAA as a useful parameter for the health status in herds. Twelve dutch dairy cows with final diagnosis(2 with amyloidosis, 3 with acute inflammatory disease and 7 with chronic inflammatory disease) were used to charify the significance of SAA determination for the diagnosis of bovine amyloidosis. The SAA concentration in the group of inflammatory disease was higher than that of amyloldotic group. Further the SAA value in the group of acute inflammatory disease was higher than that of chronic ones. To clarify the significance of SAA estimation as a useful parameter for the health status in herds, two Korean dairy farms(A and B) were selected and the SAA concentration was determined in total 76 cows(49 from A farm and 27 from B farm). The SAA concentration in cows from A farm was ranged with 0～169%. The cows with high level of SAA(31～169%) had the disease histories(1 with retained placenta, 3 with chronic mastitis, 2 with acute mastitis, 1 with abortion and acute mastitis, 1 with ovarian dysfunction, 1 with downer cow syndrome and 1 with laceration of the teat). The SAA value in the cows from B farm was ranged with 0～29% and disease history was not detected. In conclusion the SAA determination only is thought to be difficult for the diagnosis of bovine amyloidosis. Furthermore SAA estimation is thought to be a useful parameter for the health status in herds.

• Journal of Veterinary Clinics
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• v.33 no.2
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• pp.131-134
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• 2016

A 4-year-old intact female Maltese was referred to the Animal Medical Center of Chonbuk National University with a history of consistent fecal incontinence over 4 months following sacculectomy surgery. We suspected that anal sacculectomy resulted in loss of the external anal sphincter. On physical examination, the external anal sphincter muscle on the left side was intact, while the external anal sphincter muscle on the right side could not be detected and exhibited severe laceration. To repair the defect, the left semitendinosus muscle was transposed around the anus. The left semitendinosus muscle was isolated and transected near the stifle, reflected dorsally and passed around the ventral rectum into the pararectal fossa. Care was taken to preserve the integrity of the vasculature and nerve supply. The muscle was secured dorsally with simple interrupted sutures to the levator ani and coccygeus muscles to simulate the external anal sphincter. Nine days after surgery, the dog was defecating normally with no evidence of incontinence. The use of semitendinosus muscle flaps is a good option for the treatment of fecal incontinence secondary to loss of sphincter muscle in dogs.

• Journal of the Korean Society of Radiology
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• v.79 no.6
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• pp.332-336
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• 2018

Renal artery injury is a rare complication in blunt trauma, but can cause devascularization of the kidney, leading to renal failure. It requires early diagnosis and management. The treatment of renal artery injury still remains controversial, but recent studies have reported the successful treatment outcome with endovascular stent placement. Nevertheless, there is no standard treatment strategy in cases of pediatric patients. We report a case of a 16-year-old girl with right renal artery occlusion associated with a grade IV liver laceration. She was treated with only balloon angioplasty, and the kidney showed marked improvement of parenchymal perfusion with normalized renal function. Treatment with only balloon angioplasty can be a treatment option in pediatric patients with renal artery injury.

• Archives of Craniofacial Surgery
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• v.22 no.2
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• pp.99-104
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• 2021

Background: To fight the coronavirus disease 2019 (COVID-19) pandemic, many countries have implemented social distancing and lockdowns. We investigated the changes in the trauma patterns of emergency plastic surgeries in the midst of a pandemic. Methods: A retrospective review of the medical records of all patients treated for emergency plastic surgeries was performed at our hospital in Seoul. We conducted the analysis between March 1 and June 30, 2020, and compared the data obtained with that of the same period in 2019. We also investigated changes in trauma patterns according to the social distancing level from July 2020 to February 2021. Results: There was a total of 800 emergency plastic surgery patients from March to June 2020, which was less than the 981 in the corresponding period in 2019. The proportion of patients aged 7-17 years and ≥ 80 in 2020 showed a significant decrease. In 2020, patients presenting with facial trauma decreased and hand trauma, markedly laceration, increased significantly. In 2020, more injuries happened at home, whereas significantly fewer injuries happened on the streets. In 2020, slipping and sports injury decreased, whereas penetrating injury increased significantly. In the changes observed according to the social distancing level, there were significant differences in age classification, facial open wound, and the mechanism of injury. Conclusion: Social distancing has caused a change in emergency plastic surgeries. To ensure safe and appropriate treatment, strict epidemiologic workup and protective equipment are required.

• Acute and Critical Care
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• v.33 no.4
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• pp.276-279
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• 2018

In pediatric patients, a laryngeal mask airway (LMA) is usually used during minor surgeries that require general anesthesia. No esophageal injury has been reported after insertion of an LMA. We report a case of an esophageal injury with intramural dissection after an $i-gel^{(R)}$ (size, 1.5; Intersurgical Ltd.) insertion in a pediatric patient. A 2-month-old male infant was hospitalized for left inguinal herniorrhaphy. After induction of anesthesia, a trained resident tried to insert an $i-gel^{(R)}$. However, it was only successful after three attempts. Dysphagia was sustained until postoperative day 10, and the pediatrician observed duplication of the esophagus on gastroendoscopy. However, a whitish mucosal lesion, which looked like a scar, was observed, and previous lesions suggestive of esophageal duplication were almost healed on postdischarge day 11. His condition was diagnosed as dysphagia and esophagitis due to an esophageal laceration, not esophageal duplication. He was scheduled for symptomatic treatment with a proton pump inhibitor. In conclusion, although an esophageal injury or perforation in pediatric patients is rare, an LMA insertion or a procedure such as aspiration or nasogastric tube insertion should be performed gently to avoid a possible injury to the esophagus in pediatric patients.

• Archives of Craniofacial Surgery
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• v.23 no.4
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• pp.183-186
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• 2022

Plastic surgery around the eyes is usually performed under local anesthesia, using a mixture of lidocaine and epinephrine. Blindness is a rare but devastating complication after the injection of local anesthesia in this region. Most cases reported to date have been caused by occlusion of the ophthalmic artery or central retinal artery. In this case report, however, we present a highly unusual case of blindness caused by corneal edema after a local anesthetic injection. A patient visited the emergency room with a laceration on the eyebrow, and local anesthesia was injected before suturing. Immediately after the injection, severe corneal edema developed, making it impossible to observe the structures in the anterior chamber in detail or check the light reflex and visual acuity of the naked eye. An antibiotic (moxifloxacin hydrochloride) and high-concentration steroid eyedrops were promptly applied. High-concentration steroids were also administered orally. On day 13 post-injury, the visual acuity of the naked eye improved to 1.0, and no recurrence of corneal lesions was observed. Although the cause of corneal edema after the local injection could not be conclusively identified, we hope that this report will help raise clinicians' awareness of this complication and appropriate treatment methods.

• Clinical Pain
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• v.20 no.2
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• pp.127-130
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• 2021

Ultrasound (US)-guided hydrodissection (HD) is a widely applied therapeutic method to release the entrapped peripheral nerve. However, this therapy has only been studied for the nerve entrapments such as carpal tunnel syndrome, and there are no reports of its effect on direct nerve injuries with incomplete axonal damage. Here, we report a case of direct traumatic injury of a median nerve with incomplete axonal injury in a 28-year-old man. He presented hypoesthesia and weakness along with the median nerve territory of the left hand after a laceration wound of the wrist. The patient underwent a surgical procedure, but did not experience prominent improvement for the next six months. Symptoms improved after we performed the US-guided HD with dextrose. We propose this procedure as one of the new treatment methods for direct axonal injury of nerves including the median nerve.

• Medical Lasers
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• v.8 no.1
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• pp.1-6
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• 2019

Background and Objectives A facial laceration is a commonly occurring trauma of children. In addition, appropriate treatment and scar management are very important because the psychosocial impact of facial scars is much greater in children than in adults. Materials and Methods In the authors' hospital, primary closure was conducted targeting a total of 8,924 patients from January 2015 to December 2017. Of these, scar management was conducted on 808 people using a CO₂ fractional laser and Q-Switch Nd:YAG laser. To prove the effectiveness of the laser treatment on the linear scar, the patients were divided retrospectively into children and adults and sub-divided into those who received the treatment and those who did not. The subjective satisfaction of patients was evaluated using the Numeric Rating System (NRS). The objective scar scoring was evaluated using the image panel assessment based on the Vancouver Scar Scale (VSS), and the scoring was made by averaging the evaluations of three plastic surgeons. Results Evaluated NRS showed 8.50 ± 1.83 for adults without a laser, 8.51 ± 1.47 for adults with a laser, 7.93 ± 2.10 for children without a laser, and 8.9 ± 1.24 for children with a laser. The image panel assessment revealed 7.06 ± 1.31 for adults without a laser, 6.40 ± 2.37 for adults with a laser, 6.86 ± 1.45 for children without a laser, and 5.93 ± 1.21 for children with a laser. Conclusion When the linear scar is managed using a CO₂ Fractional laser, it can be managed in children better than adults, which is believed to be useful because it leads to better satisfaction and prognosis.