• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.197-200
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• 2005

Objective: Ultrasound can be used in the treatment of large intracerebral hematoma. The authors present our experiences with Ultrasound-guided catheter placement for lysis and drainage of ganglionic hematoma, with emphasis on technical aspects. Methods: The authors applied real-time ultrasonography for the aspiration of intracerebral hematoma in 6cases. Ultrasound-guided aspiration via a burrhole was performed under local anesthesia. We selected a temporal entry point instead of the frequently used precoronal approach in ganglionic hematoma. A burrhole was made 4 to 6cm posterior from posterior border of frontal process of the zygomatic bone at the level of 4 to 5cm above the external auditory meatus. Results: In all patients, the catheter was placed accurately into the hematoma target. All patients were irrigated with urokinase once to three times a day. The catheter could be removed within two or three days. The mean hematoma volume was reduced from initially 32mL to 5mL in an average of two days. There were no intraoperative complications related to the use of real-time ultrasonography and no postoperative infections were noted. Conclusion: Ultrasound allows an easy and precise localization of the hematoma and the distance from the surface to the target can be calculated. Ultrasound-guided catheter placement for fibrinolysis and hematoma drainage is a simple and safe procedure.

• The korean journal of orthodontics
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• v.17 no.1
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• pp.55-62
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• 1987

Diagnosis and treatment plans of patients are depended on cephalogram in most case. However, conventional cephalogram may change diagnosis because it ignores a conception of natural head position. The purpose of this study was to investigate the difference of head positions between conventional X-ray taking and x-ray taking in natural head position, and correlation between above results and craniofacial morphology, 60 male students in dental college, Yon sei Univ. were selected, and every cephalogram is studied by comparison of the change of head position. The results are as follows. 1. When taking X-ray by using conventional method, external auditary meatus FH was more tilted than ear rod FM by $2.1^{\circ}{\pm}1.8$ in forward and downward direction. 2. As facial form becomes concave, natural head position and head position, appeared in X-ray taking by using conventional method, become more similiar. 3. Change in head position had showed high correlations with facial form (N-A-Pog angle), and there was high significance to concave group when compared with average group, but significance to convex group was not found. 4. Multiple regression equation concerning change of head position was solved. ${\Delta}FH=24.5\;+\;0.31$ NAPog + 0.43 Prominence of Chin + 0.13 Facial length -0.32 Anterior facial height.

• Clinical and Experimental Pediatrics
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• v.50 no.4
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• pp.323-327
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• 2007

Although most clinicians now agree that sinusitis can afflict children of all ages, appropriate diagnosis remain controversial. Sinusitis is one of the most challenging diagnoses for a clinician, because there is a lack of validated diagnostic criteria for acute rhinosinusitis. Symptoms generally include nasal congestion, purulent nasal discharge, and cough .The physical examination is often unsuccessful in confirming the diagnosis. If purulent discharge is seen oozing from the middle meatus, the diagnosis of acute rhinosinusitis is almost certain. Purulent drainage may also be seen in the posterior pharynx and accompanied by halitosis. Absence of light by transillumination may indicate acute rhinosinusitis. Imaging studies are not necessary to confirm the diagnosis of sinusitis in children younger than 6 years and should be used sparingly in children older than 6 years. Sinus radiographs still have several advantages over CT scanning including the relatively low cost and the ability to obtain films without the use of sedation in younger children. Positive findings of sinusitis on plain film include air-fluid levels, complete opacification, or mucosal thickening greater then 4 mm. The CT scan however, is significantly more sensitive then plain films in detecting these abnormalities. Although recovery of bacteria from a sinus aspiration is considered reference standard for diagnosis in pediatric rhinosinusitis, its routine used by pediatricians is not practical and therefore is not recommended.

• Archives of Reconstructive Microsurgery
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• v.25 no.1
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• pp.19-24
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• 2016

Urethral reconstruction is a problematic issue, thus its management can be challenging. Different methods using various materials were introduced for urethral reconstruction. The authors have made some changes in the groin flap surgery, affording more successful urethral reconstruction for defects of long urethra and penile soft tissue. A 45-year-old male requested both functional and cosmetic reconstruction of his defected penis, caused by an iatrogenic urethral injury and chronic infection following removal of paraffin self-injected on the penile shaft. The defect affected the full length of the penile urethra, corpus spongiosum, and prepuce. A groin flap was designed, measuring $28{\times}10cm$. The most distal flap was utilized for the construction of the luminal surface of the neourethra; relaxed length measuring 8 cm, and the lumen wide enough. Competent external meatus and neourethra was confirmed by retrograde cystogram and the patient voided with sufficient urine caliber up to 2 years follow-up. This operative technique has advantages. Donor sites have non-hair bearing skin for the neourethra and minimal or almost notrecognizable donor site morbidity. After surgery, the patient was relieved from voiding difficulties combined with psychological stress. The author would like to introduce a unique approach for the urethral and ventral phalloplasty using the groin flap.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.157-160
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• 2006

Nasotracheal intubation is performed routinely in maxillofacial surgery to optimize visualization of the surgical field. The CaldwellLuc operation is an approach to the maxillary sinus through the labiogingival sulcus and canine fossa. The operation is used to treat chronic maxillary sinusitis, and involves curettage of the mucosa of the maxillary sinus and the creation of an inferior meatal antrostomy. After the operation, a nasal Foley catheter is inserted into the inferior nasal meatus for the discharge of blood and tissue fluid. Then, the nostril is packed with vaseline gauze. Before the patients awaken, they experience impaired switching from nasal to oral breathing. Pulmonary edema can result from excessive negative intrathoracic pressure caused by acute airway obstruction in patients breathing spontaneously. During anesthesia and sedation, airway obstruction can occur at the levels of the pharynx and larynx. Even in patients who are awake, alteration in the ability to change the breathing route from nasal to oral may affect breathing in the presence of an airway obstruction, causing this catastrophic event. We experienced a case in which acute pulmonary edema resulted from acute airway obstruction triggered by the patient's inability to switch the breathing route from nasal to oral during emergence from anesthesia.

• Journal of Veterinary Clinics
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• v.34 no.1
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• pp.23-26
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• 2017

Otitis externa (OE) is an inflammatory disease of the externa auditory meatus that occurs commonly in dogs. Antimicrobial susceptibility tests should be performed in case of chronic OE for successful treatment. In this study, identification and antimicrobial susceptibility test of bacteria isolated from dogs with chronic OE was performed. From 60 dogs with chronic OE, 60 bacterial species were identified. The most frequently identified species were Staphylococcus spp. (51%), followed by Pseudomonas spp. (15%) and Enterococcus spp. (14%). A single bacterial infection and multiple bacterial infections were observed in 67.5% and 32.5%, respectively. Staphylococcus spp. was susceptible to imipenum. Pseudomonas spp. was found to be susceptible to amikacin, cefepime, imipenum and piperacillin-tazobactam. Enterococcus spp. was susceptible to ampicillin-sulbactam, imipenum and piperacillin-tazobactam. Imipenum was highly susceptible antibiotic against both Gram-positive and negative bacteria whereas aztreonam and vancomycin were highly resistant. These results could suggest the optimal choice of antimicrobial agents for canine OE treatment.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.298-302
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• 1997

Ramsay Hunt syndrome is a viral associated disease with severe otalgia, vertigo, fever, herpetic eruptions on either side of the external auditory meatus and cavum concha, ipsilateral facial nerve palsy and cochleovestibular dysfunction. This syndrome may be the most common cause of unilateral facial paralysis and involvement of both the vestibular and cochlear branch of 8th cranial nerve. And loss of taste sensation may be developed in same involement site. This syndrome affects adults in most cases, and a samll number of children with herpes zoster oticus have been reported. And concomittantly CNS invlovement of this snydrome is very rare. We experienced a 7 years old aged patient of Ramsay Hunt syndrome who had evidence of aseptic meningitis, and this patient showed well reponses with Acyclovir and symptomatic therapy. So, we report this case with brief review of related literatures.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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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.

• Journal of radiological science and technology
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• v.22 no.2
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• pp.27-32
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• 1999

Cochlear implant poses a contraindication to the magnetic resonance imaging(MRI) process, because MRI generates artifacts, inducing an electrical current and causing device magnetization. CT is relatively expensive and the metal electrodes scatter the image. Post-implantation radiological studies using anterior-posterior transorbital, submental-vertex and lateral views, the intracochlear electrodes are not well displayed. Therefore, the authors developed a special view, which we call the cochlear view. The patient is sitting in front of a vertical device. Then the midsagittal plane is adjusted to form an angle of $15^{\circ},\;30^{\circ}$, and $45^{\circ}$ with the film. The flexion of the neck is adjusted to make the infraorbitomeatal line(IOML) is parallel with the transverse axis of the film. The central ray is directed to exit from the skull at point which is 3.0 cm anterior and 2.0 cm superior to the EAM(external auditory meatus). Results have shown that single radiography of the cochlear view provides sufficient information to demonstrate the position of the electrodes array and the depth of insertion in cochlear. Radiography of the cochlear view in angle of $45^{\circ}$ is an excellent image. The cochlear view gives the greatest amount of medical information with the least radiation and lowest medical cost. It can be widely used in all cochlear implant clinics.

• Journal of radiological science and technology
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• v.39 no.2
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• pp.257-262
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• 2016

This study aimed to suggest a novel method of modeling a hearing aid ear shell based on Digital Imaging and Communication in Medicine (DICOM) in the hearing aid ear shell manufacturing method using a 3D printer. In the experiment, a 3D external auditory meatus was extracted by using the critical values in the DICOM volume images, and the modeling surface structures were compared in standard type STL (STereoLithography) files which could be recognized by a 3D printer. In this 3D modeling method, a conventional ear model was prepared, and the gaps between adjacent isograms produced by a 3D scanner were filled with 3D surface fragments to express the modeling structure. In this study, the same type of triangular surface structures were prepared by using the DICOM images. The result showed that the modeling surface structure based on the DICOM images provide the same environment that the conventional 3D printers may recognize, eventually enabling to print out the hearing aid ear shell shape.