• Title/Summary/Keyword: Local complication

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Local Complication after Surgical Resection for Thyroid Disease (갑상선 질환의 외과적 절제술에 대한 국소적 합병증)

  • Cho Hyun-Jin;Cho Tae-Hyung
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.9-17
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    • 1995
  • This study was retrospectively reviewed and analysis of postoperative local complication on all patient undergoing thyroid operation of 242 cases of thyroid disease, at Department of General Surgery, Chosun University Hospital from January 1988 to December 1992. The result were follow: Postoperative local complication are as follow; 52 cases of transient hypocalcemia, 7 cases of thansient hoarseness, 3 cases of permanent hypocalcemia, 2 cases of permanent hoarseness, and other local complication were postoperative bleeding with airway obstraction, hematoma, infection. In pathologic classification according to complicative patients; The most common frequency of complication in benign disease was Graves' disease with 13 cases(54.2%), and the most frequency of complication in malignance disease was follicalar adenocarcinoma with 7 cases(53.9%). The frequency of complication according to operation procedure were unilateral lobectomy in 31 cases(19.9%), subtotal thyroidectomy in 15 cases(39.5%), near total thyroidectomy in 12 cases (44.4%), and total thyroidectomy in 10 cases(55.6%). There was a significant relationship between extent of operative procedure and frequency of complication. The incidence of local complication after thyroid resection was 57 of 196(29.1%) in the benign disease that was 15 of 26(57.7 %) in the intrathyroidal carcinoma and 13 of 20(65.0%) in the extrathyroidal carcinoma. There was significant different in frequency of local complication according to invasion and malignance of pathologic lesion. The most frequent complication after thyroid resection is transient hypocalcemia ; 39 of 196(19.9%) in the benign disease, 7 of 26(26.9%) in the intrathyroida1 carcinoma, and 6 of 10(30.0%) in the extrathyroidal carcinoma. Their complication rate increased in direct relationship to the invasion and malignance of pathologic lesion, but there was no statistically significant. Transient hypocalcemia was encountered in 52 cases of the total 242 patient(21.9%) ; 29 of 156(18.6%) after unilateral lobectomy, 9 of 38(23.7%) after subtotal thyroidectomy, and 5 of 18(27.8 %) after total thyroidectomy. The relation ship between temporal hypocalcemia and the extent of surgery was not statistically significant.

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하치조신경 전달마취 중 파절된 주사바늘

  • Jang, Jung-Hui;Song, Min-Seok;Kim, Hyeon-Min;Kim, Nam-Hun;Eom, Min-Yong;Koo, Hyun-Mo;Yi, Jun-Kyu;Yang, Byeong-Eon
    • The Journal of the Korean dental association
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    • v.44 no.2 s.441
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    • pp.139-144
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    • 2006
  • Local anesthesia is routine procedure in dental practices and has several complication. One of them, needle fracture is not uncommon in past, but rare in recent. The number of cases reported in the literature of broken needle in local anesthetic procedure has shown a marked decrease since the use of disposable spiral-constructed dental needle began. This complication results from lack of patient cooperation, inaccurate anesthetic technique, sudden movement of patient, error in the manufacturing procedure, use of short needle, and bending before use. Most common site is pterygomandibular space during inf. alveolar nerve block. In two patients, we removed broken needles under general anesthesia without complication. So we report cases with review of literatures.

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Optimum Dose Combination of External Radiation and High Dose Rate ICR in FIGO IB Uterine Cervical Cancer (병기 IB 자궁경부암의 방사선치료에서 외부방사선치료와 고선량율 강내치료의 최적선량 배합)

  • Lee Sang Wook;Suh Chang Ok;Chung Eun Ji;Kim Woo Cheol;Chang Sei Kyung;Keum Ki Chang;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.201-209
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    • 1996
  • Purpose : To assess the efficacy of high dose rate - intracavitary radio-therapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination scheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Materials and Methods : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy) Summation of external dose Plus ICR dose to the point A range were 64.20-95.00 Gy. and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Rusults : Initial complete response rate was $99.4\%$ for all patients. Overall 5-year survival rate was $91.1\%$ and 5-year disease free survival rate was $90.9\%$. Local failure rate was $4.9\%$ and distant failure rate was $4.3\%$. Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-rear survival rate was $92.6\%$ and less than 3cm, that was $79.6\%$. Late complication rate was $23.5\%$ with $18.5\%$ of rectal complication and $4.9\%$ of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gr) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication.

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A technique for treating exposed cardiac Pacemaker (피부괴사로 노출된 심장 Pacemaker에 대한 처치 : 증례 보고)

  • Sin, Geuk-Seon;Yu, Jae-Deok;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.125-128
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    • 1984
  • The management of the exposed cardiac pacemaker or its lead is a new challenge to the plastic surgeon. This complication is not rare. Coburn et al. [1972] reported less than 5 percent, but Sowton et al. [1974] showed that over a period of 19 years, in a series of 372 patients, the pacing system had to be removed because of local wound breakdown or infection in 10 percent of the cases. The methods used to treat exposure may vary from removal and re-introduction at anterior site to the rotation of local flaps to cover the exposed pacemaker. Recently we have experienced 6 times of migration and recurrent skin ulcerations without pyogenic infection overlying the pacemaker in one patient. We developed a new technique, anchoring the pacemaker to the clavicle by a wire through the hole of clavicle and by creating a pocket under the pectoralis major muscle. Then we would like to emphasize this operating method could be choice of treatment to prevent the migration of pacemaker and the ulceration of skin when complication of implantation of pacemaker is occurred.

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Removal of a broken needle using three-dimensional computed tomography: a case report

  • Kim, Jin-Ha;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.251-253
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    • 2013
  • Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

Temporary blindness caused by corneal edema after a local anesthetic injection in the eyebrow region: a case report

  • Hong, Jung Hyun;Jo, Yeon Ji;Kang, Taewoo;Park, Heeseung;Kim, Kyoung Eun;Lee, Jae Woo;Bae, Seong Hwan
    • 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.

Closed Reduction of Nasal Bone Fracture Under the Mask Ventilation Anesthesia Using Oral Airway (기도유지기 마스크 환기마취를 이용한 비관혈적 비골골절 정복술)

  • Park, Byung-Chan;Nam, Hyun-Jae;Lee, Jun-Ho;Kim, Yong-Ha;Heo, Min-Jung;Seo, Il-Sook
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.77-80
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    • 2008
  • Purpose: The majority of nasal fractures have been treated by closed reduction. And they were manipulated under local anesthesia or general anesthesia. Under the local anesthesia, patients can feel the pain and fear, so general anesthesia through the endotracheal intubation became popularized recently to treat the nasal fracture. But it has still the drawbacks of postanesthetic complication. Therefore, under the mask ventilation anesthesia using oral airway, we tried to manipulate the nasal fracture. Methods: From July 2007 to November 2007, we worked with fifty patients that were manipulated the nasal fracture. Fifty patients were divided into two groups, general anesthesia with the endotracheal intubation group(n=25) and the mask ventilation using oral airway group(n=25). We checked up the anesthesia time, postanesthetic complication, postoperative aesthetic & functional problem of nose in two groups. Results: In total operation time and sore throat frequency among the postoperative anesthetic complications, there was statistically significant difference between the mask ventilation group and the endotracheal intubation group(p<0.05). But there was no difference statistically in nausea frequency(p>0.05). And no patients complained of postoperative nasal complication such as septal deviation, septal perforation, nasal obstruction and hump nose in two groups. Conclusion: Through the mask ventilation using oral airway, we could reach satisfactory results in the anesthetic time and postanesthetic complication.

Current Status and Appropriateness of Diabetes Management in Chungbuk Region Using Community Health Survey (지역사회건강조사를 이용한 충청북도지역 당뇨병 관리 현황 및 적절성)

  • Sung-Hoon Lee;Sung-Up Choi;Jieun Yun
    • Journal of agricultural medicine and community health
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    • v.49 no.3
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    • pp.194-204
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    • 2024
  • Objectives: This study aims to assess the current status of diabetes management among residents in 11 administrative regions (Si and Gun) of Chungcheongbuk-do, using data from the 2023 Community Health Survey, and to analyze variations according to the types of local governments. Methods: A total of 12,033 residents of Chungcheongbuk-do, aged 19 and older, were selected as study participants through the 2023 Korean Community Health Survey by Korea Centers for Disease Control and Prevention. Diabetes management indicators, including blood glucose awareness, treatment adherence, and complication prevention, were analyzed using SAS Enterprise Guide version 8.3, focusing on regional differences and patterns according to local government classifications. Results: Less than half of the residents of Chungcheongbuk-do were aware of their blood glucose levels, with considerable variation observed across regions. The overall proportion of individuals receiving appropriate diabetes management in Chungcheongbuk-do was 9.6%, but the rates differed significantly between regions. For instance, Yeongdong had the highest rate of diabetes self-management education (57.5%), while Chungju had the lowest (4.3%). The frequency of regular diabetic complication screenings, such as eye and kidney exams, remained suboptimal in most regions, with many falling below 50%. Even among regions with similar local government characteristics, substantial disparities in diabetes management were identified. Conclusions: There is a pressing need for Chungcheongbuk-do and its local governments to enhance blood glucose awareness among residents and integrate comprehensive diabetes education into local health care strategies. Tailored health initiatives must be developed at the local level to improve diabetes management outcomes and reduce regional disparities, ultimately aiming to improve the quality of life for individuals with diabetes.

Dental treatment of the patient with antiplatelet agent (항혈소판제를 투여받는 환자의 치과치료)

  • Park, Hongju
    • The Journal of the Korean dental association
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    • v.57 no.10
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    • pp.606-612
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    • 2019
  • Antiplatelet agent is administered to the patients who have ischemic heart disease, transient cerebral infarction, as well as hypertension, etc. Antiplatelet agent prevents thromboembolism by inhibition of platelet aggregation by various mechanism. Due to that reason, patient who administered antiplatelet agent has bleeding tendency. Surgeon does not want to make a complication by bleeding during and after operation, and want to stop taking antiplatelet agent. However, It is very dangerous for the patient to stop antiplatelet agent. Local bleeding as a complication after operation is considered minor one, whereas thromboembolism is life threatening serious complication. Most dental intervention can be performed without withdrawal of antiplatelet agent. Dental intervention should be limited area, and surgeon should do active bleeding control.

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Late complication of the Nuss procedure: recurrent cardiac tamponade

  • Park, Won Jong;Son, Jang Won;Park, Kyu Hwan;Kim, You Min;Nam, Jong Ho;Choi, Kang Un;Kim, Jung Ho
    • Journal of Yeungnam Medical Science
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    • v.36 no.3
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    • pp.260-264
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    • 2019
  • Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.