• Journal of Chest Surgery
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• v.23 no.2
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• pp.407-415
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• 1990

A total of 69 patients were treated for congenital lung cysts at Seoul National University Hospital during the period between 1960 and Aug, 1989. They were 37 patients of bronchogenic cyst, 18 patients of pulmonary sequestration, 7 patients of congenital cystic adenomatoid malformation [C.C.A.M.], and 7 patients of congenital lobar emphysema. In cases of bronchogenic cyst, involved age was variable from 7 months to 53 years and most cases were asymptomatic. They were located 14 cases in the right lung, 6 cases in the left lung and 17 cases in the mediastinum. Their sizes were also variable from 2.5 to 12 cm and most of them except 3 cases were solitary cysts. There were 6 cases that had bronchial communication. In cases of pulmonary sequestration, aged from 3 months to 29years, all were intrapulmonary type. 15 cases of them were found in the left lower field and 3 cases in the right lower field. Anomalous vessels were confirmed in 16 cases by aortography and/or surgical exploration. In cases of congenital cystic adenomatoid malformation, aged from 7 days to 6 years, 3 cases of infants were admitted due to severe dyspnea and cyanosis but the remaining 4 cases were admitted due to large cyst or abscess on chest roentgenogram. 3 cases were located in the right lung and 4 cases in the left lung. In cases of congenital lobar emphysema, aged from 14 days to 11 years, 6 cases were located in the right lung and one case was located in the left lung. All of them were male and had shown some degree of dyspnea from birth There were 2 cases of mortality, one in C.C.A.M and one in congenital lobar emphysema. But the remaining cases were well treated and recovered with the surgical resections.

• Archives of Plastic Surgery
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• v.49 no.2
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• pp.227-239
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• 2022

Complications experienced during lymphatic surgery have not been ubiquitously reported, and little has been described regarding how to prevent them. We present a review of complications reported during the surgical management of lymphedema and our experience with technical considerations to reduce morbidity from lymphatic surgery. A comprehensive search across different databases was conducted through November 2020. Based on the complications identified, we discussed the best approach for reducing the incidence of complications during lymphatic surgery based on our experience. The most common complications reported following lymphovenous anastomosis were re-exploration of the anastomosis, venous reflux, and surgical site infection. The most common complications using groin vascularized lymph node transfer (VLNT), submental VLNT, lateral thoracic VLNT, and supraclavicular VLNT included delayed wound healing, seroma and hematoma formation, lymphatic fluid leakage, iatrogenic lymphedema, soft-tissue infection, venous congestion, marginal nerve pseudoparalysis, and partial flap loss. Regarding intra-abdominal lymph node flaps, incisional hernia, hematoma, lymphatic fluid leakage, and postoperative ileus were commonly reported. Following suction-assisted lipectomy, significant blood loss and transient paresthesia were frequently reported. The reported complications of excisional procedures included soft-tissue infections, seroma and hematoma formation, skin-graft loss, significant blood loss, and minor skin flap necrosis. Evidently, lymphedema continues to represent a challenging condition; however, thorough patient selection, compliance with physiotherapy, and an experienced surgeon with adequate understanding of the lymphatic system can help maximize the safety of lymphatic surgery.

• Archives of Craniofacial Surgery
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• v.24 no.5
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• pp.223-229
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• 2023

Background: Preauricular sinus (PAS) is a common congenital anomaly, and complete excision is recommended to prevent recurrence. However, PAS has a high recurrence rate as a result of incomplete removal due to the high variability of the sinus ramifications, making its treatment challenging. In this study, we standardized the surgical procedure to reduce the complications and recurrence rate and compared the postoperative results between the non-standardized and the standardized groups. Methods: This retrospective study included 97 patients (120 ears) who had undergone PAS excision by a single surgeon between October 2014 and September 2022 and underwent at least 6 months of follow-up. After October 2018, all patients were treated using the standardized method, which comprised the use of magnifying glasses, exploration with a lacrimal probe, the use of methylene blue staining, and excision of a piece of surrounding normal tissue and related cartilage in continuity with the specimen. There were 38 patients (45 ears) in the non-standardized group and 59 patients (75 ears) in the standardized group. Results: Recurrence was observed in six of 120 ears, indicating an overall recurrence rate of 5.0%. Recurrence occurred in five ears (11.1%) in the non-standardized group and one ear (1.3%) in the standardized group. The standardized group had a significantly lower recurrence rate (p= 0.027) than the non-standardized group. Conclusion: We defined a standardized sinectomy protocol and used it for the surgical treatment of PAS. With this standardized method, we were able to reduce the rates of complications and recurrence without the use of a long incision.

• Archives of Plastic Surgery
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• v.51 no.2
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• pp.208-211
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• 2024

Intraneural hematoma is a rare disease that results in an impaired nerve function because of bleeding around the peripheral nerve, with only 20 cases reported. Trauma, neoplasm, and bleeding disorders are known factors for intraneural hematoma. However, here we report atypical features of asymptomatic and spontaneous intraneural hematoma which are difficult to diagnose. A 60-year-old woman visited our clinic with the complaint of a palpable mass on the right calf. She reported no medical history or trauma to the right calf and laboratory findings showed normal coagulopathy. Ultrasonography was performed, which indicated hematoma near saphenous vein and sural nerve or neurogenic tumor. We performed surgical exploration and intraneural hematoma was confirmed on sural nerve. Meticulous paraneuriotomy and evacuation was performed without nerve injury. Histological examination revealed intraneural hematoma with a vascular wall. No neurologic symptoms were observed. In literature review, we acknowledge that understanding anatomy of nerve, using ultrasonography as a diagnostic tool and surgical decompression is key for intraneural hematoma. Our case report may help establish the implications of diagnosis and treatment. Also, we suggested surgical treatment is necessary even in cases that do not present symptoms because neurological symptoms and associated symptoms may occur later.

• Childhood Kidney Diseases
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• v.22 no.1
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• pp.32-35
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• 2018

Acute idiopathic scrotal edema (AISE) is a self-limiting condition that is characterized by acute scrotal swelling and erythema. AISE is a very rare cause of acute scrotum, especially in neonates. We report a case of AISE in a 26-day-old infant who was admitted to the outpatient clinic with swelling and erythema of the penis and scrotum for a week. His vital signs were stable, and laboratory findings were non-specific. A diagnosis of AISE was made using scrotal ultrasonography with color Doppler. His symptoms resolved within four days after the onset of supportive treatment, and he was discharged from the hospital. In neonates with an acute scrotum, AISE should be considered to prevent unnecessary surgical exploration.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.168-170
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• 2011

Blunt cardiac rupture is uncommon and is associated with significant mortality. Patients with blunt cardiac rupture usually have combined injury and do not always show signs of cardiac tamponade, which delays the diagnosis of cardiac rupture and increases mortality. We report a case of cardiac rupture diagnosed and treated by using only thoracic exploration based on clinical impression, with radiologic studies, including even echocardiography, showing negative results.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.320-326
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• 1985

Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.127-130
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• 1997

A 67-year old man with a history of cardiac disease underwent epidural catheterization for pain control of postherpetic neuralgia. Patient had severe back pain and pus discharge at catheter insertion site after dischange from medical part. Patient received anticoagulant therapy with $Aspirin^{(R)}$ and $Coumadin^{(R)}$ prescribed for 15 days in medical part. Magnetic resonance imaging(MRI) showed a diffuse $T_{4-7}$ anterior epidural mass compressing the spinal cord. Emergency surgical exploration revealed a thoracic epidural hematoma without abcess formation. Operation was successful and patient recovered satisfactory without any sequelae.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.125-128
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• 2013

A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain. Repeated magnetic resonance image (MRI) showed diffuse cervical epidural hematoma (EDH) extending from C5 to T1 level right side and spinal cord compression at C5-6-7 level. He underwent exploration. There was active bleeding at muscular layer. Muscular active bleeding was controlled and intramuscular hematoma was removed. The patient's symptom was reduced after second operation. Symptomatic postoperative spinal EDH requiring reoperation is rare. Meticulous bleeding control is important before wound closure. In addition, if patient presents persistent or aggravated pain after operation, rapid evaluation using MRI and second look operation is needed as soon as possible.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.154-157
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• 1980

A twenty three year old, Primigravida and 32 week pregnant woman who has been complained dyspnea, chest pain, nausea and vomiting was admitted to this chest surgical department on Feb. 19, 1979. Physical findings were those of acutely ill appearance, decreased thoracic excursion and absence of breath sounds in the left hemithorax. Roentgen examination of the chest revealed reticular cystic densities in the left, particularly in lower lung field with collapse of the left lung. Correction of the diaphragmatic hernia was carried out with reduction and repair of the hernia through transperitoneal approach. On exploration, the defect of the diaphragm was 12 x 12 cm in size and was located posterolateral area of left diaphragm. Hernia contents were stomach, spleen, omentum and splenic flexure of large bowel. The baby was normal full term spontaneous delivered at 36th POD. Diaphragmatic hernia complicated by pregnancy is a rarity and mortality is extremely high. Therefore, the literatures have reviewed and the case is reported.