• Archives of Plastic Surgery
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• 제49권3호
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• pp.457-461
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• 2022

Kaposi's sarcoma (KS) is a cancer that causes patches of abnormal tissue to grow under the skin. It also occurs in the immunosuppressive population. KS is currently believed to be caused by infection with human herpes virus-8 (HHV-8) in non-human immunodeficiency virus patient. A 79-year-old female visited the outpatient clinic presenting with increasing number and size of palpable masses on both upper and lower extremities. She was first diagnosed as drug-erupted dermatitis and stopped her medications, but the symptoms got worse. We did partial biopsy, and KS with HHV-8 was diagnosed histopathologically. She planned to undergo further evaluations and proper treatments. This rare case suggests the need to consider a classic type of KS in the differential diagnosis of specific dermatologic symptoms such as macular, nodular, and darkish patches of upper or lower extremities in elderly patients. It is believed that this case helps to strengthen awareness of this rare disease.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권6호
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• pp.342-347
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• 2022

Objectives: The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. Materials and Methods: A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables. Results: Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. Conclusion: Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.

• Parasites, Hosts and Diseases
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• 제61권2호
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• pp.194-197
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• 2023

Ascaris lumbricoides causes one of the most common soil-transmitted helminthiases globally. The worms mostly infect the human small intestine and elicit negligible or nonspecific symptoms, but there are reports of extraintestinal ectopic ascariasis. We describe a rare case of biliary ascariasis mistaken for biliary stent in a 72-year-old female patient with a history of liver resection. She visited our outpatient clinic complaining of right upper quadrant pain and fever for the past week. She had previously undergone left lateral sectionectomy for recurrent biliary and intrahepatic duct stones 2 years ago. Besides mildly elevated gamma-glutamyl transferase levels, her liver function tests were normal. Magnetic resonance cholangiopancreatography revealed a linear filling defect closely resembling an internal stent from the common bile duct to the right intrahepatic bile duct. A live female A. lumbricoides adult worm was removed by endoscopic retrograde cholangiopancreatography (ERCP). Despite a significant decrease of the ascariasis prevalence in Korea, cases of biliary ascariasis are still occasionally reported. In this study, a additional case of biliary ascariasis, which was radiologically misdiagnosed as the biliary stent, was described in a hepatic resection patient by the worm recovery with ERCP in Korea.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.

• Journal of Chest Surgery
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• 제42권4호
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• pp.497-501
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• 2009

배경: 비디오흉강경하 폐 쐐기절제수술 후 흉관을 통한 지속적인 공기유출과 흉수배액은 퇴원할 준비가 되어있는 환자의 흉관 제거를 지연시킬 수 있다. 저자는 Heimlich valve가 부착된 Panda Pneumothorax set를 장착하여 외래에서 흉관 관리를 시행한 37명의 환자를 관찰하였다. 대상 및 방법: 2005년 1월부터 2007년까지 294명에서 비디오흉강경하 폐 쐐기절제술과 흉막유착술을 시행하였다. 이중 37명의 환자가 Panda Pneumothorax set with Heimlich valve를 이용한 외래에서의 흉관 관리를 위한 대상에 적합하였다. 환자들은 쓰여진 주의사항을 받았고 Panda set사용에 대한 믿음을 보여 주었다. 환자들은 공기누출과 흉수배액의 만족할만한 소실 후 흉관 제거를 위해서 병원에 복귀하였다. 결과: Panda Pneumothorax set를 착용하고 퇴원한 환자[평균 4.7$\pm$1.4일(3$\sim$6일)]는 착용하지 않았던 환자[평균 입원일은 6.2$\pm$5일(4$\sim$9일)]와 비교할 때 보다 장기간의 입원을 하였다. 그리고 또한 Panda Pneumothorax set환자의 경우 퇴원 후 외래에서 평균 9.8$\pm$1.6일(8$\sim$15일)만에 성공적으로 흉관을 제거할 수 있었다. 주요한 합병증은 없었으며 4명의 환자에서 사소한 합병증을 보였다. 36/37명(97.3%)에서 순탄하고 성공적인 외래에서의 흉관 관리를 경험하였다. 걸론: Panda set를 이용한 성공적인 외래에서의 흉관 관리를 선택된 36명의 환자에서 성실히 수행할 수 있었다. 이런 프로그램은 결과적으로 명백한 병원비 절약을 이룰 수 있었고 조기퇴원을 가능케 하여 환자의 만족감을 증가시켰다.

• 대한골관절종양학회지
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• 제9권2호
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• pp.200-205
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• 2003

목적: 근위 비골에 발생한 거대 세포종 환자 5명에 대한 임상 양상, 치료 방법 및 결과를 보고하고자 한다. 대상 및 방법: 1997년 1월부터 2001년 7월까지 근위 비골에 발생한 거대 세포종으로 수술적 치료를 하였던 환자 중 1년 이상 추시관찰(평균 2.2년: 1.1~5년)이 가능하였던 5예를 대상으로 하였다. 모든 예에서 수술 전 단순 방사선 검사, 자기 공명 영상 검사, 핵의학 검사를 시행하였다. 모든 예에서 비골 신경을 보존하면서 일괄 절제술 및 대퇴 이두근을 이용한 외측 측부 인대 재건술을 시행하였다. 수술 후 단순 방사선 검사 및 진찰 소견으로 국소 재발의 유무를 판단하였으며 내반 스트레스 검사로 슬관절 외측 불안정을 측정하였다. 결과: 환자의 평균 연령은 23세(21~29세)였으며 남자 1예, 여자 4예였다. 모든 환자에서 병변부의 동통이 주증상이었으며 2예에서는 종물이 촉지되었다. 모든 예에서 수술 전 자기 공 명 영상 검사상 T1 강조영상에서 병변내의 저 신호 강도와 T2 강조영상에서 고 신호 강도를 보였고, Technetium-99 m을 이용한 골주사 검사상 비정상적으로 증가된 골섭취 소견이 관찰되었다. 1예에서 수술 후 일시적 비골 신경 마비를 보인 경우를 제외하고 나머지 예에서 비골 신경 마비 및 종양의 국소 재발은 보이지 않았다. 최종 추시 관찰시 5예중 1예에서 다소의 외측 불안성이 있었으나 기능상 문제가 없었으며 나머지 4예에서는 내반 스트레스 검사상 안정성을 보였다. 결론: 근위 비골에 발생한 거대 세포종은 비골 신경을 보존하면서 일괄 절제술 및 대퇴 이두근을 이용한 외측 측부 인대 재건술을 시행하여 좋은 결과를 보였다.

• 대한두개안면성형외과학회지
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• 제20권5호
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• pp.304-309
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• 2019

Background: Treatment for venous malformations of the head and neck includes sclerotherapy, surgical resection, or a combination of both. Surgical resection can remove or reduce the volume of vascular lesions; however, surgery can cause postoperative scarring and potential surgical complications. This study sought to determine the effectiveness of surgery for the treatment of venous malformations of the head and neck. Methods: A retrospective review of the medical records of patients who received surgeries for venous malformations of the head and neck from January 2011 to July 2019 was performed. Using clinical photographs, preoperative and postoperative Doppler ultrasonography, outpatient clinic records, and operation records, the postoperative result and complications were evaluated for each case. Results: Among patients who visited our vascular anomalies clinic, 43 patients (ratio of male to female= 24:19) received surgeries for venous malformations of the head and neck. Twenty-nine patients had undergone surgery only, five patients received sclerotherapy after surgery, and nine patients received surgery after preoperative sclerotherapy. In postoperative evaluations, the result was excellent in 24 patients, good in 18 patients, and poor in one patient. Four patients experienced a recurrence of lesions with lagophthalmos, drooping of the corner of the mouth, partial wound necrosis, and scar widening found in one patient each. Conclusion: Because the head and neck region is the most exposed area in the body, more active implementation of surgical treatments with or without sclerotherapy is essential to reduce the functional and cosmetic impairments associated with venous malformations.

• Journal of Chest Surgery
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• 제53권1호
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• pp.16-21
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• 2020

Background: Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. Methods: The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. Results: Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. Conclusion: Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.16-22
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• 2019

Background Various surgical techniques have been used to correct Tessier number 7 craniofacial cleft, which involves macrostomia, ear deformity, and hemifacial microsomia. To achieve symmetrical and satisfactory results in patients with macrostomia, the authors performed a 1-mm medial overcorrection on the cleft side and evaluated the results of this procedure. Methods A retrospective medical record review of patients diagnosed with Tessier number 7 craniofacial cleft from March 1999 to February 2017 was performed. Using clinical photographs, outpatient clinic records, and operative records, information was recorded regarding concurrent congenital anomalies, postoperative complications, and follow-up. Using Photoshop CS2, the length of both sides of the lip was compared. The ratio of these lengths was calculated to evaluate lip symmetry. Results Of the patients treated at the Department of Plastic and Reconstructive Surgery at Kyungpook National University Chilgok Hospital, 11 (male-to-female sex ratio, 7:4) were diagnosed with Tessier number 7 craniofacial cleft. Concurrent congenital anomalies included skin tag, hemifacial microsomia, and cleft palate. The mean duration of follow-up was $78.273{\pm}72.219$ months and the mean ratio of the lengths of both sides of the lip was $1.048{\pm}0.071$. Scar widening occurred as a postoperative complication in some patients. No cases of wound infection, bleeding, or wound dehiscence occurred. Conclusions For the successful correction of macrostomia, plastic surgeons should consider both functional and aesthetic problems of the lip. Adequate repair of the orbicularis oris muscle, skin closure with Z-plasty, and medial overcorrection of the neo-oral commissure led to good results in our patients.

• Journal of Chest Surgery
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• 제48권4호
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• pp.281-284
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• 2015

We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.