Journal of agricultural medicine and community health
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v.20
no.2
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pp.169-174
/
1995
The case was described of a 31 year old female who developed fusiform swelling of the right third finger at the site of puncture by sea urchin spine. We observed a radiopaque linear material suggesting a remnant spine which the size was 2.4 mm in sonography and mammography. We confirmed that it exhibits a urchin spine and distinct caseous necrosis with central calcification. Sea urchins(Echinoidea) are ubiquitous marine creatures that resemble pincushions and are covered by calcareous skeletons surrounded by numerous movable calcium carbonate spines. The sharp spines are brittle and easily detach when touched by the victim. Contact with sea urchin spines produces intense pain, some localized erythema and edema. Inflammation develops in response to retained fragments. Granulomas 1-5 mm in diameter develop rarely 2-12 months after envenomation. In treatment, hot water immersion and thorough wound cleansing are advisable. Analgesics may, be necessary after hot water immersion. Attempts to remove these spines should be performed with good lighting sources, preferably with radiological direction. Chronic granulomas usually require complete excision. Acetone has been suggested for rapid resolution of pain. No antidotes are available.
Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won;Kim, Jong-Gue
Journal of Korean Neurosurgical Society
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v.45
no.2
/
pp.67-73
/
2009
Objective : Although endoscopic procedures for lumbar disc diseases have improved greatly, the postoperative outcomes for high grade inferior migrated discs are not satisfactory. Because of anatomic limitations, a rigid endoscope cannot reach all lesions effectively. The purpose of this study was to determine the feasibility of endoscopic transforaminal suprapedicular approach to high grade inferior-migrated lumbar disc herniations. Methods : Between May 2006 and March 2008, a suprapedicular approach was performed in 53 patients with high grade inferior-migrated lumbar disc herniations using a rigid endoscope and a semi-rigid flexible curved probe. One-to-four hours after surgery, the presence of remnant discs was checked with MRI. The outcomes were evaluated with the visual analogue scale (VAS) score and the Oswestry Disability Index (ODI) one week after surgery. Results : The L2-3 level was involved in 2 patients and the L3-4 level was involved in 14 patients, while the L4-5 level was involved in 39 patients. There were single piece-type in 34 cases and a multiple piece-type in 19 cases. Satisfactory results were obtained in all cases. The mean preoperative VAS for leg pain was $9.32{\pm}0.43$ points (range, 7-10 points), whereas the mean ODI was $79.82{\pm}4.53$ points (range, 68-92 points). At the last follow-up examination, the mean postoperative VAS for leg pain was $1.78{\pm}0.71$ points and the mean postoperative ODI improved to $15.27{\pm}3.82$ points. Conclusion : A high grade inferior migrated lumbar disc is difficult to remove sufficiently by posterolateral endoscopic lumbar dscectomy using a rigid endoscope. However, a satisfactory result can be obtained by applying a transforaminal suprapedicular approach with a flexible semi-rigid curved probe.
Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. We present a case of solid type PIOSCC in a 52-year-old male patient complaining of dull pain on his left lower molar. In this case, early stage PIOSCC mimicking a periapical lesion might lead to a one-year delay in treatment due to the misdiagnosis of osteomyelitis after extraction of the third molar. The clinical, radiological, and histologic features are described. In this case, there was initial radiographic evidence for PIOSCC mimicking a periapical lesion. Incautious radiographic interpretation and treatment procedures had delayed the correct diagnosis and resulted in extensive bony destruction during the patient's disease progression.
Purpose: We aimed to analyze the effect of fixation tightness of the syndesmotic screw and its indwelling period on the recurrence of the syndesmosis widening after screw removal and the clinical outcomes. Materials and Methods: Forty consecutive patients with acute syndesmotic injury were retrospectively reviewed. The tibiofibular clear space is measured by digitalized measurement tool on serial radiographs. We analyzed the effect of time from trauma to fixation, syndesmotic screw indwelling duration, and fixation methods. Residual symptoms at the last follow up were evaluated. The student t-test, correlation test, and chi-square test were used for statistical analysis. Results: Eighteen ankles (45%) had recurrent syndesmosis widening (greater than 5% compared to the contralateral side). Seven patients had pain and five had limitation of motion in the ankle joint. Fixation tightness had significant effect on reducing the recurrence while the severity of the initial widening, time to fixation, and duration of fixation did not affect the outcome. Conclusion: Tight fixation of syndesmotic screw is essential for achieving final syndesmotic stability and reducing recurrence.
Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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v.18
no.2
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pp.90-99
/
2004
High speed info-communications equipment are required with development of highly information-oriented society, the intelligent industrial facilities and social systems such as administrative, financial and traffic systems, are gradually becoming to automation, which are composed of the integrated circuits and micro-semiconductors, remote control and operation. Thus modern micro-electronic circuits can frequently be damaged by lightning surge. The protection of electronic circuits from lightning overvoltages is concentrated very interesting. In this paper, for the purpose of providing the effective protection method of electronic devices such micro-computers from lightning surges in a residential building, the protection effect of surge protective devices according to types of system groundings were experimentally analyzed. Also the effective installation method of surge protective devices was examined and proposed. The installation of SPDs in retrofits was a high remnant voltage across the protected device owing to the inductance in the long wires to the SPDs. Finally the method of installing the SPD by twisted pain wires is remarkably effective for fast rising transient overvoltages.
Jo, Kwanag-Wook;Kim, Sang-Don;Chung, Eun-Yong;Park, Ik-Seong
Journal of Korean Neurosurgical Society
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v.49
no.2
/
pp.120-123
/
2011
We present a rare case of optochiasmatic cavernous angioma (CA) that progressed despite radiation therapy. A 31-year-old female patient presented with sudden loss of left visual acuity and right homonymous hemianopsia. Magnetic resonance imaging (MRI) revealed a suprasellar mass and findings compatible with a craniopharyngioma or an optic glioma with bleeding. An open biopsy was conducted using the transcranial approach, and histological examination revealed gliosis. During the one-year follow-up period, imaging suggested intratumoral bleeding and the mass continued to grow. We recommended re-operation, but the patient refused due to fear of surgery. Consequently, the patient received fractionated radiation therapy (3,000 cGy) to the parasellar area. Despite the radiotherapy, the mass continued to grow for the following 6 years. The final MRI before definitive treatment revealed a multi lobulated, multistage hematoma with calcification in the parasellar area, extending into the third ventricle and midbrain. The patient ultimately underwent reoperation due to the growth of the tumor. The mass was completely removed with transcranial surgery, and the pathologic findings indicated a cavernous angioma (CA) without evidence of glioma. As shown in our case, patients may suffer intratumoral hemorrhage after biopsy and radiotherapy. This case places the value of biopsy and radiotherapy for a remnant lesion into question. It also shows that reaching the correct diagnosis is critical, and complete surgical removal is the treatment of choice.
Purpose: Electrogastrography is a method of measuring action potentials of the stomach. The purpose of this study was to investigate early postoperative changes in the electrogastrography and determine the correlation between electrogastrography and quality of life of patients with stomach cancer who underwent distal gastrectomy. Materials and Methods: This study analyzed 20 patients with stomach cancer who underwent electrogastrography and quality of life was measured 1, 12, and 24 weeks after the operation. Quality of life-C30 version 3.0 and quality of life-STO22, were used. Results: Fasting and postprandial mean dominant frequency at 1 week after the operation was 2.7 and 2.7 cycles per minute, and 2.8 and 2.7 cycles per minute at 12 weeks, 2.6 and 2.8 cycles per minute at 24 weeks. Fasting and postprandial mean dominant power at 1 week was 36.5 and 36.4 dB, 36.3 and 40.1 dB at 12 weeks and 40.9 and 42.3 dB at 24 weeks. The percentage of tachygastria was increased whereas the percentage of bradygradia was decreased during the postoperative periods (P<0.05). Global health, physical, emotional and social functioning scales were improved, but role and cognitive functioning were not changed. Pain, insomnia, diarrhea and financial difficulties were significantly improved according to the postoperative periods (P<0.05). The correlation between the STO22 and electrogastrography parameters was not significant (P>0.05). Conclusions: These may suggest that electrogastrography is a simple and noninvasive method and may be applicated for evaluating motility and autonomic functions of the remnant stomach.
Kim, Eui Sik;Kim, Sung Nam;Noh, Bok Kyun;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
Archives of Plastic Surgery
/
v.33
no.3
/
pp.347-352
/
2006
Ingrowing toenail has been treated conventionally by various surgical treatment modlities. However, none of these procedures are perfect to achieve esthetic results with low cost, recurrence, and complication rates. Although mild cases can be treated conservatively, in severe recurrent cases, surgical treatment is preferred. The purpose of this study is to evaluate the effectiveness and safety of using partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail. Eight patients suffering from recurrent ingrowing toenail were operated using partial matricectomy and paronychial advancement flap in our department from August 2004 to August 2005. The number of recurrent episodes ranged from 2 to 5. With digital nerve block, the excision area was marked on nailplate and inflammed lateral nail fold. The horizontally designed paronychial flap considering defect size was effective for wide exposure of the neighboring germinal matrix, which is later to be completely excised or cauterized because remnant germinal matrix made postoperative spicule formation. The nailplate on the affected side was removed about 3-5 mm width longitudinally, being cautious not to damage the proximal dorsal nail fold. The same width of the sterile matrix including germinal matrix was excised longitudinally with inflammed granulation tissue and partial lateral nail fold on the affected side. The subcutaneously elevated paronychial flap was advanced to cover the defect and was anatomically sutured with 5-0 nylon sutures. We evaluated our procedure's effectiveness by examining some factors such as cosmetic results, recurrence, spicule formation, postoperative pain and duration of return to normal activities. In eight patients, no complication was observed such as recurrence, severe pain and spicule formation except for 1 case of infection. Postoperative discomfort was minimal. Average duration of return to normal activities was 12 days. Cosmetically the results were acceptable in all patients. The partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail were found to be technically simple, efficient procedure with a relative low recurrence rate and better cosmetic results.
Purpose : After the total or partial meniscectomy of the lateral discoid meniscus, many patients complain the residual pain or the recurrent symptoms of the meniscus, and some of them need reoperation. We analyzed the causes of the reoperation after initial meniscectomy. Material & Method : Two hundred seventy three patients with the symptomatic lateral discoid meniscus were treated by arthroscopic meniscectomy between October, 1989 and September, 1998. Of the 273 patients, 69 patients were treated by total meniscectomy and 204 patients were treated by partial meniscectomy. The male to female sex ratio was 1:1.04, and the average of the age was 23.1 years old(from 4 to 59 years old). The reoperation was done in 8 patients, of which 1 was the case of total meniscectomy at the initial operation, and the rest 7 were the case of partial meniscectomy. Results : Of the 8 reoperations, 3 patients recurred the meniscal symptoms within the 3rd week after the initial operation, and 5 patients recurred beyond the 3rd week after the initial operation. Among the 3 patients of carly recurrence, 2 patients showed inadequate sizes of the remnant meniscus, and 1 patient showed posterolateral instability of the remained meniscus. Among the 5 patients of late recurrence, 3 patients showed rerupture of the meniscus, and 2 patients showed associated pathology of degenerative arthritis following osteochondritis dissecans. Conclusions : The reoperation rate after initial meniscectomy of the lateral discoid meniscus was higher in partial meniscectomy than total meniscectomy. During the operation of the lateral discoid meniscus, we must determine the adequate resectional margin, confirm the remnant meniscus by probing, and look for the associated pathologies.
A clinical study of 36 cases of pulmonary tuberculosis that had had a surgical resection during the period of 13 years from January 1979 to December 1992 was performed in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital The ratio between male and female was 3.5 1 and the age of peak incidence was in the 2nd and 3rd decades. The common prodromal symptoms were chest pain (38.9 %) and hemoptysis or blood tinged sputum (36.1 %). Preoperative diagnostic examination of sputum positivity for AFB stain despite antituberculosis chemotherapy was noticed in 22.8 oyo . Surgical indications were destroyed lobe or segment with or without cavity (58.3 oyo), mass unable to differentiate from lung cancer (16.7 %), total destroyed lung (13.9 %), bronchostenosis with atelectasis and distal bronchiectasis (11.1 %). Types of resection were pneumonectomy in 16.7%, lobec omy and segmentectomy 2.7%, lobectomy 50 %, segmentectomy 27.8%, and wedge resection 2.7%. Postoperatively, pulmonary function Improved compared to the preoperative examination, although these changes were not statistically significant. One patient died of ulcerative colitis due to drug hypersensitivity, and the postoperative complications were remnant dead space in 11.1 %, spreading of tuberculosis in 5.5%, and empyema with BPF in 5.5%.
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