• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.186-190
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• 2017

We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months' outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.2
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• pp.104-107
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• 2009

Midazolam, one of the most common benzodiazepine derivatives, is widely used in intravenous sedation for dental treatment without severe complications. However, paradoxical reactions to midazolam, including patient's unanticipated restlessness, agitation, hostility, and rage, have been frequently reported since the introduction of benzodiazepine. During outpatient intravenous sedation using midazolam for dental treatment, we experienced a paradoxical reaction to midazolam in a 28-year-old female patient. With a thorough review of the literature, the management of this complication and its various etiologies were discussed.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.101-105
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• 2023

Benign cartilaginous tumors, known as chondrogenic tumors, show cartilage components in the microscopic diagnosis. We present two clinical cases with cartilaginous tumors of the toes showing distinctive clinical manifestations. Two juvenile patients visited our outpatient clinic due to tumors with toenail deformities. A 10-year-old girl presented with a palpable mass with a nail deformity on the left third toe. The initial pathology report was soft tissue chondroma until complete resection. Another 15-year-old male patient visited the dermatology department with a toenail deformity and underwent a punch biopsy. The pathology report was fibrosis with myxoid degeneration. Excisional biopsies were performed for both patients. In the operative field, we observed exophytic tumors connected to the distal phalangeal bones. The final pathology reports were subungual osteochondroma on both patients. The specimen exhibited mature bone trabeculae with a focal cartilaginous cap. Benign cartilaginous tumors have a slow, progressive course and do not show significant symptoms. However, tumors in subungual areas are accompanied by toenail deformities and they can cause pain. Their clinical characteristics lead to a delayed diagnosis. Surgeons can be confused between soft tissue and chondrogenic tumors. When they conduct physical examinations, these categories should be considered in the differential diagnosis.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.778-780
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• 2010

A 48-year-old female complained of edema and pain in her left neck. She underwent acupuncture therapy for 1 month in a local oriental medicine clinic because of her arm pain. Computer tomography showed left internal jugular vein thrombosis. The patient's condition improved after antibiotic medication and anticoagulation. The patient is currently in outpatient department follow-up and doing well. To the best of our knowledge, this is the first report of an internal jugular vein thrombosis secondary to acupuncture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.436-441
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• 2000

The purpose of this retrospective study is to investigate the effects of conscious sedation in an outpatient setting. Data from 292 patients (154 males, 138 females), sedated for minor oral surgery, were studied using various parameters including age and sex distribution, as well as according to procedures and each drug group. Results show that this intravenous conscious sedation technique is a safe and effective method of controlling behaviour, but one has to be prepared to deal with any emergencies or complications. The specific results are as follows: 1. Most procedures (265/292) were used to Valium mixed with Demerol and Midazolam mixed with Demerol. 2. Valium revealed a high incidence of pain upon injection and symptoms limited to daily activity and thrombophlebitis. 3. Nausea and vomiting manifested in the procedure using Demerol. 4. The patient manifested comfort similar in response to the same drugs used in another treatment.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.250-254
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• 2005

Burns due to epileptic seizures are commonly deep and usually require operative treatment. The purpose of this study is to identify the characteristics of burned epileptic patients that could lead to the development of preventive programs to reduce the incidence of burn injuries. We analyzed epidemiological data for 34 patients acutely burned due to epileptic seizure admitted retrospectively. There were 15 male and 19 female subjects. The age distribution was from 6 years to 70 years with the mean age of 42.7 years. Seizures usually occurred while carrying out daily domestic chores. Scalding burns were the most common(38.2%) and most burns were above deep second degree(94.1%). The most common seizure type was generalized tonic-clonic, followed by absence and complex partial. The seizure mostly occurred in the morning because the therapeutic blood level of antiepileptic drugs was decreased extremely at that time by stopping drug arbitrarily or taking inadequately. So more frequent follow-ups at the neurology outpatient clinics for epileptics should be strictly reinforced to maintain the adequate therapeutic blood levels of antiepileptic drugs and fire protective implements should be prepared in the house.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.496-498
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• 2008

Cardiac papillary fibroelastomas are the second most common primary cardiac tumor. This tumor is usually benign and it involves the cardiac valve. However, most cardiac papillary fibroelastomas originate from a single site, and the incidence of cardiac papillary fibroelastomas originating from multiple sites is very rare (5%). A 55-year-old woman who presented with momentary dizziness and syncope was evaluated by performing echocardiography. Multiple tumors attached to the aortic valve were noted. The mass was removed freely without leaving any defect on the aortic valve leaflet. After the recovery period, the patient is currently being followed up at the outpatient department.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.8-12
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• 2011

Rotator cuff disease is one of the most common shoulder problems. When dealing with patients suffering from rotator cuff disease, whether to perform surgery or not is the most common difficulty faced by the outpatient clinic. Choosing the adequate operation time as well as the method of operation is important when deciding to perform surgery. Selecting the type of non-surgical treatment is an important issue when opting not to perform surgery. This review article will focus on the decision-making process involved in the treatment of rotator cuff disease.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.65-68
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• 2013

Muir-Torre syndrome is defined by concurrent or sequential development of internal malignancy and sebaceous neoplasm or multiple keratoacanthomas. Muir-Torre syndrome is very rare, with only 205 cases reported in the literature. We reported a patient with Muir-Torre syndrome with three internal malignancies. A 64-year-old patient with a history of breast cancer, stomach cancer and colon cancer visited our department for treatment of the skin lesion that occurred five years before on the left cheek. The lesion was excised completely with a resection margin of 1 cm, followed by full-thickness skin graft from left postauricular area for reconstruction. Histopathology revealed a $0.2{\times}0.2{\times}0.1cm$ sized sebaceous carcinoma with 4 mm safety margin. The skin graft was well taken within 7 days after surgery and the patient was discharged to outpatient follow-up. There was no complication related with surgery. Muir-Torre syndrome is very rare, as are sebaceous gland tumors. So if a cancer of the sebaceous gland is diagnosed, screening workup for internal malignancy is recommended. Because of its good prognosis, surgical removal of primary or metastatic cancers may be curative and should be attempted where possible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.315-320
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• 2021

Carbon-ion radiotherapy (CIRT) is on the rise as a treatment choice for malignant tumor. Compared to conventional radiotherapy, particle beams have different physical and biological properties. Particle beam provides a low entry dose, deposits most of the energy at the endpoint of the flight path, and forms an asymptotic dose peak (the "Bragg peak"). Compared to protons, carbon with its larger mass decreases beam scattering, resulting in a sharper dose distribution border. We report a 50-year-old male who underwent CIRT without surgical resection on osteosarcoma of the mandible. After CIRT, the patient's pain was gone, and the malignant mass remained stable with accompanying necrosis. Nine months later, however, magnetic resonance imaging demonstrated progression of the left mandibular osteosarcoma with pulmonary metastases. After multidisciplinary discussion, concurrent chemoradiotherapy was conducted. While necrotic bone segments came out of the mandible during subsequent periodic outpatient visits, the tumor itself was stable. Thirty months after his first visit and diagnosis, the patient is waiting for chemotherapy. Although CIRT is superior in treating radioresistant hypoxic disease, CIRT is in its infancy, so care must be taken for its indications and complications.