• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.1
• /
• pp.53-56
• /
• 2010

Carcinoma ex pleomorphic adenoma is transformed at the incidence of 1-20% in pleomorphic adenoma and frequently recurred. It accounts for 10% of all malignant salivary tumors and its average age of occurrence is 60s. It will present in a large, long-standing pleomorphic adenoma or in one that was previously treated but has recurred. According to cell composition in malignant cell carcinoma, and clear cell adenocarcinoma. Most (75%) occur in parotid gland, while about 20% occur in the minor gland of the oral mucosa. The metastasis rate to regional lymph node is about 25%, and to distant organs about 33% and the 5-year survival rates are 40%. Though the treatment of the carcinoma ex pleomorphic adenoma is not established, it is treated ideally with and extensive resection, neck dissection, postoperative radiotherapy, and chemotherapy. When occurred in parotid gland, facial paralysis is reported. With a review of literatures, we report a case of carcinoma ex pleomorphic adenoma which operated with total parotidectomy and supraomohyoid neck dissection.

• Archives of Plastic Surgery
• /
• v.35 no.6
• /
• pp.687-691
• /
• 2008

Purpose: An inverted nipple presents both cosmetic and functional problems. It is a source of repeated irritation and inflammation, and interferes with nursing. In addition, its abnormal appearance may cause psychological distress. With consideration of its underlying pathophysiologic components and severity, a number of techniques have been introduced for correction of this anomaly. The diversity of techniques indicates the lack of a good, sustainable, and durable solution for this quite common problem. We report our method as an alternative solution for correcting of the inverted nipple. Methods: From August 2003 to November 2007, 273 nipples in 147 patients were treated. 126 patients had bilateral inverted nipples. Patient age at the operation ranged from 21 to 63 years(mean age, 34 years). All nipples were congenital anomaly. 45 nipples were graded as grade I, 179 nipples as II, and 49 nipples as III. In the our study, we made some modification to the classic purse-string suture: (1) twice purse-string suture: (2) excision of diamond-shaped skin at the nipple neck: (3) buried suture of the breast parenchyma at the nipple base: (4) some timely release of retraction using Bovie's electrocautery dissection at inner surface of the nipple neck. Results: The operation time averaged 15 minutes. The mean follow-up period ranged from 3 to 48 months, with an average of 8.4 months. There were no complications associated with the surgery, such as infection, hematoma, permanent sensory disturbance, or total nipple necrosis except temporary sensory loss in 9 cases, partial nipple necrosis in 7 cases, and recurred inversion in 15 cases. All patients except recurred inversion were satisfied with their results. Conclusion: We believe that our modified purse-string suture is a reliable, simple, safe, and effective method for correcting the inverted nipple.

• Journal of Chest Surgery
• /
• v.23 no.4
• /
• pp.731-735
• /
• 1990

Simultaneous and non simultaneous bilateral spontaneous pneumothorax patients[273] were reviewed retrospectively from April 1986 to March 1990 in the Dept. of Thoracic and Cardiovascular Surgery, Kyung Hee University Medical College. The incidence of bilateral spontaneous pneumothorax was 13.6%[37] and sexual distribution was male dominant [Male:33, Female:4]. The patients were classified into three major groups according to therapeutic methods: Group I [7]; who were treated with simultaneous bilateral operation for unilateral recurred spontaneous pneumothorax through median sternotomy. Mean age was 20.7 years[17 \ulcorner28] and follow up duration was 7.7 months [3 weeks \ulcorner2 years]. Group II [23];who were treated with staged lateral thoractomy, unilateral thoracotomy and non simultaneous contralateral closed thoracostomy, or simultaneous or non simultaneous bilateral closed thoracostomy. Mean age was 28.6 years [17 \ulcorner56] and follow up duration was 9.8 months[one week \ulcorner3.5 years]. Group III[10] ;who were treated with simultaneous bilateral operation for simultaneous or non simultaneous bilateral spontaneous pneumothorax through median sternotomy. Mean age was 21.4 years[17 \ulcorner28] and follow up duration was 12.8 months[2 weeks \ulcorner2.7 years]. Among the patients managed through median sternotomy simultaneously [Group I and III], there were visible blebs or bullous changed lesions mainly in the apicoposterior segment bilaterally in 15 patients[88.2%] Postoperative complications were 3 cases in Group II [wound infection:2 cases, temporary left wrist drop: one case] but none in Group I and III. Spontaneous pneumothorax recurred in 2 cases, one in Group II and another in Group III but none in Group I. 12 cases of 94 patients[12.8%o] who were treated with unilateral thoracotomy needed contralateral thoracotomy mean 14.9 months[7.5 \ulcorner 25 months] later. Mean age was 20.9 years [17 \ulcorner28]. In conclusion, simultaneous bilateral operation through median sternotomy should be considered in managements of spontaneous pneumothorax, especially in late teens and early twenties except young women for cosmetic reasons.

• Journal of Yeungnam Medical Science
• /
• v.29 no.1
• /
• pp.19-23
• /
• 2012

Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.

• Journal of Korean Neurosurgical Society
• /
• v.39 no.2
• /
• pp.87-91
• /
• 2006

Objective : Management of recurrent vestibular schwannomas[VS] after microsurgery or radiosurgery is a complicated subject. However, few studies have documented the outcome of recurrent VS. The authorsreviewclinicalexperience of recurrent VS management and analyzed the efficacy of treatment modalities. Methods : Between 1990 and 2002, 293 patients harboring unilateral VS underwent, microsurgery, radiosurgery, microsurgery followed by radiosurgery. Of these, 26 procedures [in 20 patients] were performed to assessed from an increased tumor size by magnetic resonance imaging[MRI]. The mean age of patients with recurred VS was 46.9 years and the mean follow-up period was 68 months. Radiological characteristics were investigated and growth rates of recurred tumors were calculated by measuring changes in tumor diameter on MRI after treatment. Results : MRI characteristics revealed a lobulated contour in 75% and a cyst in 60% of the patients. Only 1 patient showed neither lobulation nor a cyst. The average diameter of the recurrent tumors were 36.9mm. The overall tumor control rate for initial management was 87.4%, 94.7%, and 98.5% for microsurgery, radiosurgery, and microsurgery plus radiosurgery, respectively. However, control rates for recurrent tumors were lower at 85%, 63%, and 80%, respectively. Conclusion : A cystic nature and a lobulated tumor contour are frequent clinical characteristics of recurrent VS. Microsurgery or microsurgery followed by radiosurgery shows little difference in tumor control rate for primary and recurrent VS. However, radiosurgery alone appears to be less beneficial for recurrent VS.

• Journal of Korean Foot and Ankle Society
• /
• v.7 no.1
• /
• pp.55-60
• /
• 2003

Purpose: To analyze the clinical results of excision of the symptomatic or recurred ganglion cysts of the foot and ankle. Materials and Methods: Twenty-one cases of the ganglions located in the foot and ankle area were followed for more than 12 months postoperatively. There were 9 males and 12 females, and the mean age was 42.3 years (range, 11-71 years). The mean duration of follow-up was 2.3 years (range, 1.1-4.1 years). Clinically previous treatment, size and location of the cyst, preoperative and postoperative AOFAS foot score, postoperative complication and satisfaction of patients were evaluated. Results: As a previous treatment, 7 patients received mean 1.3 bouts of aspirations, and 6 patients were recurred after mean 1.5 bouts of operations. The size of cyst ranged from 1.4 cm to 5.1 cm with the mean size of 2.7 cm. The cyst was most common in the dorsum of the foot and ankle, where 14 cases were found. Preoperative mean AOFAS foot. scores were low in the cysts associated with the tarsal tunnel syndrome, which was 71 points, and in the cyst of the plantar aspect of the 1st toe, which was 79 points. Postoperative mean AOFAS foot scores were significantly increased to 91 points and 92 points in preceding two groups. There were 2 cases (9.5%) of recurrence, both of which had satellite mass along the tendon sheath. Conclusion: Care should be taken in the diagnosis and treatment of ganglions in the tarsal tunnel and in the plantar aspect of the 1st toe. In case of ganglion cysts originated from the tendon sheath, consideration should be given for possible satellite mass.

• Archives of Plastic Surgery
• /
• v.36 no.1
• /
• pp.96-100
• /
• 2009

Purpose: Angiosarcoma of the scalp is unusual vascular tumor originating from endothelial cell. Angiosarcoma is an aggressive tumor with high propensity for both local recurrence and distant metastasis. We report 2 cases of angiosarcoma having poor prognosis recently. Methods: Case 1 was a 67 - year - old male patient. He visited the hospital with a $3{\times}5cm$ sized discolored mass in forehead. It began at one month ago from coming to the hospital. Case 2 was a 64 - year - old male patient. He visited for our hospital to remove a $4{\times}5cm$ sized scalp mass. He had a pruritis on scalp from 9 months ago before coming to the hospital. Despite of the conservative treatments, the wound was not healed and advanced necrotic lesion with hemorrhage. Results: Case 1 diagnosed as an angiosarcoma. He underwent a radical operation 5 times. But the tumor expanded multiple area in dura & frontal area of the brain. The patient rejected the treatment any more. And he died one month later. Case 2 diagnosed as an angiosarcoma and metastased to skull in MRI. He got a radical resection including cranium. Three months later, it recurred to ipsilateral Sternocleidomastoideus muscle. He got a additional operation & started radiotherapy. And now he is receiving chemotherapy, but the recurred lesion is expanding. Conclusion: Angiosarcoma is a highly malignant tumor. Especially it arises in vascularized area, it easily metastases. So it is the best to treat angiosarcoma with surgery included wide margins. Despite of the lesion is small, we remember that angiosarcoma is a tumor that consider to metastases.

• Archives of Plastic Surgery
• /
• v.47 no.3
• /
• pp.267-271
• /
• 2020

The latissimus dorsi musculocutaneous flap (LDMCF) is widely used for breast reconstruction. However, it has the disadvantage of frequent seroma formation at the donor site, and late seroma has also been reported. The authors report histological findings after the surgical treatment of a late, repeatedly recurrent seroma at 10 years after breast reconstruction with LDMCF. In 2008, a 66-year-old female patient underwent immediate breast reconstruction with LDMCF. In 2015, a late seroma was found at the donor site. After aspiration and drainage, the seroma recurred again in 2018. Total surgical excision of the seroma was performed and bloody-appearing fluid was identified in the capsule. The excised tissue was biopsied. Histological examination revealed no evidence of blood in the fluid, and multinucleated giant cells with amorphous eosinophilic proteinaceous material were identified. The cyst was suggestive of chronic granulomatous inflammation. There was no recurrence at 8 months postoperatively. The patient described herein underwent surgical treatment of late seroma that recurred after immediate breast reconstruction with LDMCF, and histological findings were identified. These results may be helpful for other future studies regarding late seroma after breast reconstruction with LDMCF.

• Journal of Chest Surgery
• /
• v.40 no.10
• /
• pp.715-718
• /
• 2007

Neurogenic tumors of the brachial plexus are rare. An malignant schwannoma originates from the schwan cells or nerve sheath cells. Occasionally, schwannomas are associated with Von Rechlinghausen's disease, but this is rare. We were recently presented with a thirty-five year old female patient with a history of pulmonary tuberculosis about ten years prior. The patient also presented with a mass that has been slowly growing for one year. Onset of pain occurred six months after the tumor began to grow. The mass was $5{\times}7cm$ in size. The patient underwent on bloc resection of the tumor as the mass recurred twice in spite of postoperative radiotherapy.

• Journal of the Korean Data and Information Science Society
• /
• v.25 no.3
• /
• pp.555-565
• /
• 2014

The purpose of this study was to analyze sports injuries which occurred in Korea National Team during official training period. All sports injuries are recorded on injury report form by physicians, medical staffs and athletic trainer, and only acute and recurred injuries were analyzed. Total 3,421 injuries were reported, and 1,560 injuries were newly incurred and 1,861 injuries were recurrent with previous history. The frequency of new injuries in male and female athletes was highest in boxing (n=130, 14.5%) and hockey (n=75, 11.3%) respectively. The frequency of recurred injuries in male and female athletes was highest in wrestling (n=147, 14.8%) and fencing (n=103, 11.9%) respectively. Our data provides incidence rates, characteristics of acute and recurrent sports injuries during official training period and thus these results could provide relevant information for the sports injury prevention at Korea National Team player.