• Title/Summary/Keyword: Out-patient anesthesia

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Mucosa-associated lymphoid tissue lymphoma on right lower eyelid previously diagnosed as lymphoid hyperplasia

  • Kim, Yang Seok;Na, Young Cheon;Huh, Woo Hoe;Kim, Ji Min
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.66-70
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    • 2019
  • Mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon form of non-Hodgkin lymphoma involving the mucosa-associated lymphoid tissue. Most commonly affected organ is the stomach. But, it could affect almost every organ in the whole body. If they have suspicious lesion, excision biopsy could be made. For staging, blood test including blood smear, abdomen and chest tomography or scan will be checked. Also, bone marrow test can be done if it is needed. The patient had visited the clinic for palpable mass on right lower eyelid. With excisional biopsy, it was diagnosed as lymphoid hyperplasia on pathologic test. But 2 years later, the patient came with recurrent symptom for our department with worry. At that time, we recommended excisional soft tissue biopsy under general anesthesia. Unfortunately, it was revealed MALT lymphoma on pathologic finding. It turned out to be stage 3 in Ann Arbor staging system without B symptoms. Hematologic consultation was made and she was treated with adjuvant chemotherapy for eight cycles to complete remission. We report a case of MALT lymphoma on subcutaneous tissue at right lower eyelid previously diagnosed as lymphoid hyperplasia.

Hepatic Tuberculous Granuloma with Subphrenic Abscess - A Case Report - (늑막직하 농양을 동반한 결핵성 간장 육아종 1례 치험)

  • Jeong, Sang-Jo;An, Jae-Ho;O, Seong-Tae
    • Journal of Chest Surgery
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    • v.24 no.6
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    • pp.585-589
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    • 1991
  • We experienced a rare hepatic tuberculous granuloma with subphrenic abscess. The patient was 45-years old female. She complained the right flank pain and tenderness on the protruding mass for 2 weeks. It was fixed, erythematous and 5x5cm sized mass, which was thought as cold abscess. She has done the hysterectomy as endometriosis at November 1990. Under general endotracheal anesthesia, the mass was incised, but the pus was not found. The needle aspiration was done through the 8th ICS, then the yellowish non-foul odor pus was rushed out. The 7th and 8th ribs were resected segmentally about 5cm. The abscess cavity was placed in the subphrenic area, therefore the operative fields extended along the 8th ICS. After the evacuation of subphrenic abscess, the granulomatous tissues from the superior aspect of liver was seen. The granuloma was resected and the penrose drainage was inserted. The tuberculosis was resulted from the 8th ICS muscles. subphrenic abscess and granuloma on the pathology report.

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Two Cases of esophageal foreign body removal using Fogarty catheter (Fogarty 카테터를 이용한 식도 이물(바둑알) 제거 2예)

  • 박시내;박경호;박준욱;여상원;조승호
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.79-82
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    • 2003
  • Unintentional foreign body ingestion is common in children, and coins are the most common foreign body ingested. Foreign body remaining in the esophagus may be associated with mucosal ulceration or esophageal obstruction and can potentially lead to significant morbidity and even death. Removal of esophageal foreign body is therefore generally recommended. Several methods are utilized including esophagoscopy in operating room, flexible endoscopy in out patient setting, fluoroscopic Foley catheter technique, and advancement using bougienage. We report two cases of esophageal foreign body(paduk stone) which were hard to be removed by usual esophagoscopic removal. Successful removal was accomplished with the aid of Fogarty catheter under the general anesthesia.

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Late Results of Operation for Patent Ductus Arteriosus with Preoperative Pulmonary Hypertension (폐동맥고혈압을 동반한 동맥관개존증의 장기관찰 성적)

  • O, Bong-Seok;Jo, Wan-Jae;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.775-780
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    • 1989
  • This study concerns the late results observed at follow-up[average: 32.5 months] of 23 patients, in whom Patent Ductus Arteriosus with pulmonary hypertension among 55 patients. They were operated from May 1984 to July 1987 in Chonnam University Medical School. There was predominance of woman [2.5:1]. No operative death occurred. All of patients subside preoperative symptoms, but 1 patient diagnosed recannalization of duct at follow-up. Systolic murmur was found over the pulmonary area in 5 patients [22 %], but it may be not related to systolic pulmonary arterial pressure[SPAP]. Also, SPAP were normalized in 74 % of patients and had mild hypertension in 26 % of patients. Although the patients had Patent Ductus Arteriosus with pulmonary hypertension, successful surgical correction was carried out safely in all instance but one, by ligation and facilitated by hypotensive anesthesia.

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Midface Infection after COVID-19 Vaccination in a Patient with Calcium Hydroxylapatite Dermal Filler: A Case Report and Literature Review

  • Jeon, Hong Bae;Yoon, Jae Hee;Lim, Nam Kyu
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.310-314
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    • 2022
  • The emergence of vaccines for coronavirus disease 2019 (COVID-19) raises risk of possible adverse events from interaction between the vaccines and facial aesthetic care. A 47-year-old female with no medical comorbidities visited our emergency room due to midface painful swelling after 3 hours following receiving the second dose of the messenger RNA BNT162b2 COVID-19 vaccine. About 14 years ago, she underwent nonsurgical augmentation on the nasojugal groove with a calcium hydroxylapatite dermal filler. We performed incision and drainage under general anesthesia on the next day. During operation, yellowish pus-like materials bulged out. After an operation, we performed a combination therapy with antibiotics and methylprednisolone. Her symptoms improved day by day after surgery, and then a complete recovery was achieved at 3 weeks after the treatment. In conclusion, providers of aesthetic procedures are to be aware of the potential risks of such vaccines for patients who already had or seek to receive dermal filler injections.

The Postoperative Pain Control for the Benign Prostatic Hypertrophy: Continuous Epidural Pain Block versus Intravenous Patient-Controlled Analgesia (양성 전립선 비대증 환자의 술후 통증치료)

  • Park, Sun-Gyoo;Kim, Jin-Yun;Rah, Eun-Gil
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.268-272
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    • 1998
  • Background: Postoperative bleeding is a common complication in transurethral resection of prostate (TURP). Some patients become restless and combative after operation, particularly when in pain, producing bleeding from the prostatic bed. So many patients may be necessary to pain control for reduce bleeding. The purpose of this study is to compare recently used two Methods for post-operative analgesia. Methods: We studied 40 patients, ASA physical staus 1, 2, undergone TURP under general anesthesia. The patients divided into two groups: continuous epidural pain control group (I, n=20) received an epidural bolus of morphine 2 mg and 1% lidocaine 10 ml followed by a epidural 0.08% bupivacaine 40 ml and morphine 4.5 mg (basal infusion rate 0.5 ml/hr), intravenous patient-controlled analgesia (IV-PCA) group (II, n=20) received an intravenous bolus of fentanyl $50\sim100{\mu}g$ followed by a IV-PCA morphine 30 mg, ketorolac 180 mg and droperdol 2.5 mg (basal infusion rate 0.5 ml/hr, bolus 0.5 ml, lock-out interval 15 min). This study conducted the analgesic efficacy, side effect and patient's satisfaction for 1 day after TURP. Results: Continuous epidural pain control group had more significant analgesia than IV-PCA at postoperative 30, 60 min, but no significant difference was observed later in both group. Nausea and pruritus were scantly developed in both group but the incidence was no significant differeance. Patients responded good satisfaction over 70% in both group. Conclusions: Postoperative continuous epidural pain block and IV-PCA are both effective Methods of postoperative pain control with lower incidence of side effects.

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A CASE OF INTRAORAL SURGICAL TREATMENT FOR CHILDREN WITH HEMOPHILIA (Hemophilia 환아의 관혈적 치과치료에 관한 증례보고)

  • Lee, Joon-Kyun;Lee, Keung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.589-594
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    • 2005
  • With the progress of medical treatment techniques of bleeding control, dental care of the patient with hemophilia has become more convenient. So many surgical treatments can be performed with out-patient. 2 cases of intraoral surgical treatment of children, one with hemophilia 3, sever, the other with hemophilia A, severe. While the former was treated under general anesthesia, the latter was treated under local anaesthesia. There are principles : 1. When a patient with hemophilia need dental treatment, the dentist must consult to his physician, pediatrician, or hematologist before dental treatment. 2. When the dentist make a treatment plan, there should be consideration of the general condition, cooperation of the patient and risk of the treatment needed. 3. Minimize the number of times of coming for dental treatment so that reduce the times that need replacement therapy of coagulation factor. And during the treatment, dentist should care for infection and bleeding.

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Pain and quality of life related to suture removal after 3 or 7 days at the extraction sites of impacted lower third molars

  • Rodanant, Pirasut;Wattanajitseree, Kannika;Shrestha, Binit;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.2
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    • pp.131-136
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    • 2016
  • Background: This study aimed to evaluate the patient's pain and quality of life after suture removal at either 3 or 7 days following the bilateral surgical extraction of impacted lower third molars. Methods: This study was a prospective, randomized controlled clinical trial carried out in 30 patients, who acted as their own control. Each patient required the bilaterally impacted mandibular third molars to be extracted. The impacted teeth were removed and the wound margins were approximated and sutured with black braided silk. The suture material was removed on day 3 on one side and on day 7 on the other. Each participant was asked to complete a questionnaire after the removal of the suture material on each designated day. Results: Regarding overall clinical symptoms, the mean VAS scores of male and female participants on day 3 were not significantly different from those on day 7. A significant difference was found in female participants, in that overall daily activity was better on day 7. There were significant differences in the ability to smile and laugh in both sexes and the ability to chew in the male participants was better on day 7. Conclusions: There were no significant differences in the patient's pain and quality of life between suture removal on day 3 or on day 7 following surgery to remove impacted lower third molars.

Inadvertent Dural Puncture during Epidural Block (경막외 차단시의 경막천자)

  • Kang, Keum-Ye;Min, Ki-Chul;Kim, Dong-Chan;Choe, Huhn
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.203-206
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    • 1988
  • Evaluation of inadvertent dural puncture occuring among 308 epidural blocks done for the relief of pain from various conditions was performed. Dural puncture was suspected in 5 out of 308 epidural bloks. (1.6%) Aspiration of CSF was negative in 3 cases in which dural puncture was suspected only after developing spinal anesthesia. Of the 3 negative CSF aspirations, one case had a history of laminectomy. Adhesions of the adjacent tissues might result in the loss of flexibility and a decrease in potential epidural space which might cause dural tearing during injection and subarachoid injection of the local anesthetic followed by high spinal anesthesia. In another case, the needle tip was obstructed by tissue which led to negative aspiration of CSF and failure to feel loss of resistance. The second injection at the same site may cause subarachnoid injection of the local anesthetic through the previously perforated dura mater and in turn, lead to spinal anesthesia. In the last case, there was no reason to suspect dural puncture since the loss of resistance plus air rebound were definite and aspiration of CSF was negative, but dural puncture was suspected after the patient developed spinal anesthesia.

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Short Term Outcomes and Prognostic Factors Based on Radiofrequency Thermocoagulation on Lumbar Medial Branches (요추 후지내측지에 대한 고주파열응고술의 단기 성적과 예후 인자)

  • Choi, Byung In;Kweon, Tae Dong;Park, Kyung Bae;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.116-122
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    • 2007
  • Background: Lumbar zygapophysial joints are a common source of chronic lower back pain and radiofrequency thermocoagulation (RF) of the medial branches (MB) has been shown to be effective at providing substantial pain relief for chronic low back pain. Therefore, we carried out this study to determine the short term outcomes and prognostic factors of RF on the MB of patients with lumbar facet syndrome. Methods: We performed RF in fourteen patients who showed greater than 80% pain relief up to three times after a diagnostic MB block was conducted using 0.3 ml of 0.5% bupivacaine. Using 10 cm curved electrodes with 10-mm active tip, a 60 second, $80^{\circ}C$ lesion was made after electrical stimulation at 50 Hz for sensory and 2 Hz for motor nerve testing. The degree of pain relief was then assessed after 2 weeks, and again after 3 months using a visual analog scale (VAS) and a four point Likert scale. The outcome was regarded as 'success' if at least a 50% reduction in the VAS was observed. Possible prognostic factors between the two groups were also evaluated Results: The success rate was 71.4% (10/14) after three months of follow-up. However, there were transient complications, such as neuritis like syndrome, in 4 patients. In addition, short symptom duration and low minimal voltage (< 0.4 V) for sensory stimulation were shown to be the relevant prognostic factors for a successful outcome. Conclusions: RF may be an alternative to repeated MB block or intraarticular injection for palliation of lumbar facet syndrome. For better outcomes, early diagnosis and strict patient selection should be coupled with efforts to avoid anatomically incorrect RF.