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하악 과두하 골절시 후하악 접근법에 의한 수술 후 발생한 이하선 누공 형성과 이에 대한 치료 증례 (Retromandibular approach for the management of subcondylar fractures, followed by treatment of parotid gland fistulae: Case report)

  • 노재찬;김주원;양병은
    • 대한치과의사협회지
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    • 제55권10호
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    • pp.696-705
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    • 2017
  • Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.

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의료명상(MDCT)을 이용한 간 동맥의 영역 분할에 관한 영상처리 (A Study on an Image Processing for Segmentation of Liver Arteriography Using Medical Image(MDCT))

  • 최승권;조용환;이병록
    • 한국콘텐츠학회논문지
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    • 제5권5호
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    • pp.305-305
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    • 2005
  • 현대사회에 있어서 질병은 매우 다양하게 발견되고 있다. 또한 한번 발병하면 아니면 적절한 검진시기를 놓쳐 돌이킬 수 없는 상황을 접하게 되는 경우가 종종 있다. 사회가 발전하면서 과도한 비즈니스와 음주 흡연 등으로 우리의 간은 매우 피곤한 상태에 놓이게 되며 질병 발생율도 매우 높다. 여러 질병 중 특히 간에 관련된 질병은 회복이 불가하여 장기이식수술에 의존하는 편이다. 이와 관련하여 본 연구는 MDCT로 얻어진 영상을 3차원 영상 기법으로 간의 형상을 렌더링 하여 체적을 구하고 간 이식 수술시 혈관과의 분리 작업을 통해 절개 라인을 결정할 수 있도록 미리 시물레이션 할 수 있는 영상처리 기법을 개발하고자 간 영역 자동 추출 알고리즘을 적용하여 시물레이션 한 결과 수술을 용이하게 집도할 수 있도록 새로운 장을 열게 되었다.

Multidirectional Vector Excision Leads to Better Outcomes than Traditional Elliptical Excision of Facial Congenital Melanocytic Nevus

  • Oh, Seung Il;Lee, Yoon Ho
    • Archives of Plastic Surgery
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    • 제40권5호
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    • pp.570-574
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    • 2013
  • Background The elliptical excision is the standard method of removing benign skin lesions, such as congenital melanocytic nevi. This technique allows for primary closure, with little to no dog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scars which are unnecessarily long. This study was designed to compare the predicted results of elliptical excision with those resulting from our excision technique. Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. After an incision on one side of the nevus margin, subcutaneous undermining was performed in the appropriate direction. The skin flap was pulled up and approximated along several vectors to minimize the occurrence of dog-ear deformity. Results Overall, the final wound length was 21.1% shorter than that achieved by elliptical excision. Only 8.5% of the patients required dog-ear repair. There was no significant distortion of critical facial structures. All of the scars were deemed aesthetically acceptable based on their Patient and Observer Scar Assessment Scale scores. Conclusions When compared to elliptical excision, our technique appears to minimize dogear deformity and decrease the final wound length. This technique should be considered an alternative method for excision of facial nevi.

원위 쇄골 골절 2a 형에서의 경피적 환상 강선 고정술 -1례 보고- (Percutaneus Cerclage Wiring in Distal Clavicle Fracture Type 2a - One Case Report -)

  • 김재화;이순철;조덕연;윤형구;이윤석
    • Clinics in Shoulder and Elbow
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    • 제9권1호
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    • pp.124-129
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    • 2006
  • Distal clavicular fracture frequently requires operative treatment due to high rate of non-union. The operative technique includes the tension band wiring, K- wire fixation, and cerclage wiring etc. Each method has disadvantages somewhat like pin migration or acromioclavicular joint injury and so on. For the distal clavicular fracture type 2a, because of its oblique fracture line, the cerclage wiring is suitable. We performed the cerclage wiring percutaneously under minimal incision without injury to periosteum for the patient who had the distal clavicular fracture type 2a, and the result was favorable.

아킬레스건 파열 이후에 발생한 종골 결절의 견열골절: 증례 보고 (Calcaneal Tuberosity Avulsion Fracture after Repair of Achilles Tendon Rupture: A Case Report)

  • 이성현;이영;김성배;강홍제
    • 대한족부족관절학회지
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    • 제23권4호
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    • pp.216-219
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    • 2019
  • In clinical practice, recurrent Achilles ruptures have been noted to occurr at the original ruptured site. However, reports of new developed fresh rupture of the Achilles tendon in other sites are is extremely rare. Our report is about one uncommon case of a traumatic calcaneal tuberosity avulsion fracture following augmented repair, which was performed using the Krackow locking loop technique. We performed open reduction and intra-osseous fixation using a suture anchor. This procedure was done through the primary longitudinal incision for the calcaneal avulsion fracture fragment. After 6 months of follow-up, our patient has achieved a complete functional recovery and he can normally perform daily and work-related tasks without pain.

기도협착을 유발한 흉선낭종 (Thymic Cyst Causing Tracheal Stenosis : one case report)

  • 황정주;양홍석;백효채;홍순원;이두연
    • 대한기관식도과학회지
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    • 제11권1호
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    • pp.25-27
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    • 2005
  • Thymic cysts are uncommon tumors which usually occur in the neck and mediastinum. It is known to arise from embryonic remnants of the thymopharyngeal duct or from infammation of thymic tissues. Patients with thymic cyst are often asymptomatic and identified after surgical removal and histologic examination. We experienced a 73 year-old man with recently developed dyspnea. During the examination, chest CT showed a $5{\times}6cm$ sized cystic mass causing deviation of the trachea. It was located in between the right thyroid gland and anterior mediastinum. It also caused tracheal narrowing noted by bronchoscopy. Right anterior cervical incision and removal of the mass was performed and a histological diagnosis of thymic cyst was confirmed. The patient was discharged without complication.

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원발성 기관종양의 수술치험 9례 보고 (Surgical Treatment of Tracheal Tumors [9 cases])

  • 이두연
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.792-799
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    • 1985
  • Primary neoplasms of the trachea are rare, but are a very serious critical life-threatening disease. Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest C-T, tomogram and air tracheogram are essential for the further definition of these lesions. The need for removal of tracheal tumors whether complete or incomplete, is clear enough regardless of the histology of the tumor. We have experienced 9 cases from Jan. 1965 to June, 1985. One patient with tracheal hamartoma was cured with complete resection through rigid bronchoscopy and another patient with fibrous histiocytoma was treated with re-excision and laser evaporation through superior mediastinotomy due to recurrence, 1 year later. The remaining patients were treated with mass excision or segmental resection and end-to-end anastomosis through collar incision and superior mediastinal sternotomy. The remaining two patients were operated with and segmental resection and end-to-end anastomosis of trachea using partial cardiopulmonary bypass. The histologic diagnosis were adenoid cystic Ca[5], fibrous histiocytoma[1], mucoepidermoid Ca[1]. hamartoma[1], anaplastic Ca.[1]. Three patients were treated post-operatively with radiation; with adenoid cystic Ca.[2] and anaplastic Ca.[1]. Their post-operative courses were uneventful during the follow-up from 2 months to 7 years.

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좌측 주기관지 외상성 단절의 지연복원 -1례 보고- (Delayed Repair of Completely Transected Left Main Bronchus-A report of one case-)

  • 류한영;박이태;한승세
    • Journal of Chest Surgery
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    • 제23권3호
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    • pp.572-576
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    • 1990
  • A complete transection of left main bronchus was repaired by end to end anastomosis 5 months after the chest trauma in the Yeungnam University Hospital. The patient was a 36 years old male who had been injured bluntly by a heavy package on the left chest. The initial symptoms and signs were dyspnea, chest pain and subcutaneous emphysema on the left neck, but on admission at our hospital his chief complaint was only mild left chest discomfort. The preoperative chest X-ray findings 5 months after the trauma revealed total collapse of the left lung, deviation of trachea to the left, elevation of left diaphragm, abrupt discontinuation in the course of an air-filled left main bronchus and bronchoscopy showed that the left main bronchus was completely occluded, without any signs of inflammation, approximately 4 cm from the carina. The operation was performed through standard posterolateral thoracotomy incision at the fifth intercostal space. There was not any suppuration within the transected lung but plenty of white mucus which was removed by forceful suction. The transected bronchial edges were debrided and anastomosed primarily by end to end with interrupted nonabsorbable sutures. The suture line was reinforced with a pleural flap. The postoperative course was uneventful and pulmonary function following operation improved progressively and proved the delayed repair to have a reasonable decision.

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Intraocular Foreign Body Entering the Anterior Chamber Through the Mouth: A Case Report

  • Kim, Joon-Young;Kim, Kyung-Hee;Jeong, Soon-Wuk
    • 한국임상수의학회지
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    • 제34권1호
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    • pp.58-60
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    • 2017
  • An 11-year-old, castrated Maltese dog presented with a 3-week history of periocular swelling, epiphora, and intermittent strabismus. On examination, a foreign body was observed in the anterior chamber, along with orbital cellulitis. Severe gingivitis and plaque accumulation were also diagnosed. The foreign body was surgically removed, and dental prophylaxis and dental extraction were performed. The foreign body entrance could not be found intraoperatively, and the foreign body, later identified as a feather, was removed through a clear corneal incision. The right maxillary molar, which had periodontal inflammation, was also extracted. One day postoperatively, severe hypopyon developed, although the periocular swelling was reduced. These signs persisted despite topical and systemic antibiotic and anti-inflammatory therapy; therefore, the right eye was enucleated 1 week later. Intraoperatively, a fistula was found connecting the orbital medial wall, right maxillary molar root, and sclera. The fistula entered the dorsomedial sclera approximately 7 mm behind the limbus. Enterobacteria were cultured from the area. Foreign bodies can enter the anterior chamber not only through the cornea, but also through the mouth. Therefore, when the entry point cannot be found in the cornea, a careful dental examination is required, and the foreign body must be removed through the sclera rather than the cornea.

파워숄더 재킷의 어깨 구성 방법과 디테일 대응 분석 (A study on the shoulder composition methods of power shoulder jackets and corresponding details)

  • 박정아;이정란
    • 복식문화연구
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    • 제29권3호
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    • pp.388-405
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    • 2021
  • This study classifies the compositional methods of power shoulder jackets from 1980 to the present. It analyzes the relevance of jacket details according to how the power shoulder changes and its compositional methods by era. The research subdivides shoulder compositional techniques into seven, based on shoulder variation, sleeve variation, and the body and sleeve combination. The researcher investigates the frequency and trends of composing shoulders and analyzes details pertaining to the silhouette, jacket length, collar shape, and front closure. The most common method of shoulder composition is an angular shoulder variation. The others are a rounded shoulder variation, puffed sleeve, sleeve variation using pattern incision, raglan and kimono sleeves, and a shoulder variation that expanded the angle and width. The frequency differs slightly for each era. The relationship between shoulder compositional methods and details of power shoulder jackets is statistically significant, showing period-related differences. The homogeneity analysis results reveal that the shoulder composition of power shoulder jackets, the times, and details fall into distinct groups. This analysis shows that the silhouette, length, collar, and front closure of the power shoulder jacket differ depending on the power shoulder's compositional methods. Moreover, the shape of the power shoulder jacket is distinctly different. One can use this data to help develop the power shoulder jacket design by reflecting the details of shoulder compositional methods and changing trends over time.