• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.664-670
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• 2020

Lipofibromatous hamartoma (LFH) is a rare tumor of the peripheral nerves, which usually involves the median nerve. The authors reported on two rare cases of carpal tunnel syndrome due to LFH of the median nerve. A 49-year-old female patient complained of the mass and symptoms consistent with LFH. Magnetic resonance imaging (MRI) showed typical LFH findings. The symptoms were successfully ameliorated with carpal tunnel release and external neurolysis. A 37-year-old female patient complained of weakening thumb abduction and the mass where the MRI showed atypical findings. Opponensplasty and debulking operations were performed after which thumb abduction was improved; however, neurological sequelae remained. LFH of the median nerve is managed on a case-by-case basis as treatment guidelines are not very clearly defined yet. However, the less invasive treatment such as carpal tunnel release and external neurolysis than more aggressive surgical treatment should be recommended as a treatment option.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.42-45
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• 2007

Spinal cord lipomas are commonly associated with spinal dysraphism. The lipomas without spinal dysraphism have been reported to be only 1% of all spinal cord lipomas. We report two cases of patients with spinal intramedullary lipomas without dysraphism. One patient was a 57-year-old man who had lower back pain and right-sided sciatica for 20 years. Magnetic resonance imaging (MRI) of the spine demonstrated an intradural mass occupying L1 to L2. The other patient was a 27-year-old woman who had back pain and gait disturbance for 5 months. MRI of the spine showed an elongated intradural mass occupying T7 to T9. Total laminectomy with partial resection of the lesions was performed on both patients. Pathological studies confirmed the diagnosis of spinal cord lipoma. They exhibited no dysraphism. Postoperatively, neurological symptoms improved in both patients.

• Journal of Chest Surgery
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• 제33권1호
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• pp.88-95
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• 2000

Pulmonary lymphangioleiomyomatosis is a chronic destruct8ive disease of the lung affecting women of childbearing ages which eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic measure because this disease responds poorly to other therapies, To date only a few reports in the literature describes the clinical experience of the bilateral sequential lung transplantation of this rare condition. We performed a bilateral sequential lung transplantation on a 32-year-old woman suffering from lymphangioleiomyo-matosisw. The heart-lung block was harvested from a 51-year-old donor. We transplanted the left lung first through the clam-shell incision. As the hemodynamics deteriorated suddenly during the dissection of the right lung the right lung was transplanted under the cardio-pulmonary bypass. Although the patient's lung function was initially satisfactory the patient died of sepsis and subsequent cardiogenic shock at the postoperative 18th day. Autopsy findings showed infection of Candida albicans on the pericardium and the left lung which had been initiated possibly from the left bronchial anastomosis site,. Through detailed review of the clinical course we concluded that lung transplantation could have been performed safely on this disease provided that early diagnosis and proper management or the oppor-tunistic infection have been carried out.

• Journal of Chest Surgery
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• 제26권3호
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• pp.224-227
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• 1993

We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

• 대한골관절종양학회지
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• 제7권2호
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• pp.59-63
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• 2001

연골육종이 소아의 종골에 발생한 경우는 매우 드물다. 13세 환자가 수개월간 지속된 우측종골 부위의 통증으로 내원하여 시행한 방사선 검사상 우측 종골의 골밀도의 증가 및 석회화와 피질골 파괴, 그리고 종골 주위 조직의 석회화 침범 소견이 관찰되었고, 조직검사상 원발성 연골육종으로 진단되어 슬하부 절단술 및 술후 항암요법을 시행하였으며 12개월째 경과 관찰중이며 재발이나 원격전이는 발견되지 않았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.718-725
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• 1996

Histiocytosis X is the abnormal proliferation of histiocytes and usually a massive aggregation of eosinophilic leukocytes. The clinical features and prognosises of subclasses of histiocytosis X depend on the severity and extent of the organ involvement. The subclasses include Letterer-Siwe disease(Acute disseminated histiocytosis X), eosinophilic granuloma, Hand-Schuller-Christian disease. Letterer-Siwe disease(acute, subacute form) refers to the form of disease that is most often fatal because of the widespread skeletal, extraskeletal lesion ; this usually affects infants and children less than 3 years of age. Eosinophilic granuloma(histiocytosis X, localized) refers to a chronic form of disease with skeletal lesion ; It usually affects children and young adult. Hand-Schuller-Christian disease(chronic form) refers to a chronic form of disease with skeletal, extraskeletal lesions. It usually affects children over the age of 3 years. In our hospital, 8 year old female patient visited complaining of hard swelling of mandibule body, left side and 6 year old female patient visited complaining of painful swelling of mandibular angle, right side. We diagnosed eosinophilic granuloma and curetted the lesiones and refered to Dept. pediatrics for chemotherapy. We present 2 cases to you with literatures.

• 대한치과마취과학회지
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• 제5권1호
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• pp.22-24
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• 2005

General anesthesia is often required for mentally retarded children undergoing extensive dental treatment. We experienced a case of dental treatment under general anesthesia in a 14-year-old boy with mental retardation. He was treated on an outpatient basis. He was diagnosed of Noonan syndrome and received heart surgery when he was six years old. Induction using thiopental and vecuronium was uneventful and nasotracheal intubation were carried out. General anesthesia was maintained with sevoflurane for 2.5 hours. After monitoring the patient for 2 hours and confirming his recovery, he was discharged from the day care unit. In summary, we report this successful anesthetic management of a mentally retarded child during dental treatment in as an out-patient.

• 구강회복응용과학지
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• 제19권4호
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• pp.317-323
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• 2003

When making crown and bridges on anterior regions, many practitioners consider the esthetics the most. For this reason functional aspect are not considered as much as the esthetics. If the occlusion on the anterior region are not formed correctly, movement of the temporomandibular joint can be disturbed and excessive stress can be occur that pathologic condition can be under lied. On this case presentation will show the importance of the anterior guidance and suggest the appropriate protocol of using customized anterior guide table. A 45years old male had to remake both of the upper central and lateral PFM because of the porcelain fracture. The new PFM crowns were made conventional methods without considering the anterior guidance. After the temporary setting, the patient complained of discomfort and short looking upper anteriors. To solve these problems we had to restore the palatal contour and length of the new crowns by making customized anterior guide table using temporary crowns that contains patient's old anterior guidance. This procedure which is copying the pt's comfortable anterior guidance to the final prosthesis made them to be esthetic and patients to feel comfortable.

• 한방안이비인후피부과학회지
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• 제24권3호
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• pp.129-137
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• 2011

Objective : Foville syndrome & Foville-Millard-Gubler syndrome is a disease characterized by facial palsy, ipsilateral conjugate gaze palsy and ipsilateral internal strabismus. There has never been a clinical report of this disease in oriental medicine. Since gradual improvement has been experienced with oriental medical treatments based on facial palsy and paralytic strabismus in this case, it is worthwhile to introduce this disorder and report the case referring to clinical record. Methods : 75-year-old female patient and 45-year-old male patient suffering right facial palsy, right conjugate gaze palsy and right internal strabismus were treated with acupuncture, herbal medicine, pharmacopuncture and electroacupuncture. Result : Concurrence of right facial palsy, right conjugate gaze palsy and right internal strabismus was diagnosed with Foville syndrome or Foville-Millard-Gubler syndrome which is generally caused by the impairment of PPRF, abducens and facial nerves on the affected side and showed improvement with oriental medical treatments. Conclusion : More accurate diagnosis, more aggressive treatments and further researches are all required on this disease afterwards.

• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.89-92
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• 2014

An 8-year-old girl diagnosed with dilated cardiomyopathy and Russell-Silver syndrome was admitted to our pediatric intensive care unit due to low cardiac output and multiple-organ dysfunction. The patient was placed on the heart transplant waiting list and extracorporeal membrane oxygenation was performed as a bridge to transplantation. After 17 days, heart transplantation was performed. The donor was a 46-year-old female (weight, 50 kg; height, 150 cm). The donor:recipient weight ratio was 3.37:1. Because the dimension and volume of the recipient's thoracic cage were insufficient, the sternum could not be closed. Nine days after transplantation, the patient underwent delayed sternal closure. To obtain adequate space, we left the sternum 4.5 cm apart from each margin using four transverse titanium plates. A transverse rectus abdominis musculocutaneous flap was chosen to cover the wound. Due to the shortage of donors, a size-mismatched pediatric heart transplantation is sometimes unavoidable. Closure of the opened sternum of a transplant recipient can be challenging. Sternal reconstruction after an extremely oversized heart transplantation with transverse titanium plate fixation and a musculocutaneous flap can effectively achieve sternal closure and stability.