• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.1
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• pp.43-47
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• 2019

The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an "inhomogeneous solid lesion in the nasal fossa". With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.219-224
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• 2021

The aim of this review is to introduce the progress in trauma surgery made during war. In the 16th century, Paré reintroduced ligature of arteries, which had been introduced by Celsus and Galen, instead of cauterization during amputation. Larrey, a surgeon in Napoleon's military, adapted the "flying artillery" to serve as "flying ambulances" for rapid transport of the wounded. He established rules for the triage of war casualties, treating wounded soldiers according to the seriousness of their injuries and the urgency of medical care. To treat fractures and tuberculosis, Thomas created the "Thomas splint", which was used to stabilize fractured femurs and prevent infection; in World War I (WWI), use of this splint reduced the mortality of compound femur fractures from 87% to less than 8%. During WWI, Cushing systematized the treatment of head injuries, reducing mortality among head injury patients. Gillies repaired facial injuries, and his experiences became the basis of craniofacial and aesthetic surgery. In WWII, McIndoe discovered that immersion in saline promoted burn healing and improved survival rates, and thus began saline baths and early grafting instead of using tannic acid. A high mortality rate in patients with acute renal failure was noted in WWII and the Korean War. In the Korean War, Teschan used the Kolff-Brigham dialyzer. The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by the US Army in Burma during WWII. As a lotus blooms in the mud, military surgeons have contributed to trauma surgery during wartime.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.13-20
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• 2022

The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

• Journal of Korean Neurosurgical Society
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• v.67 no.3
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• pp.376-381
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• 2024

Choroid plexus hyperplasia (CPH), also known as diffuse villous hyperplasia of choroid plexus, is a rare condition characterized by excessive production of cerebrospinal fluid (CSF), resulting in hydrocephalus. Diagnosing CPH can be challenging due to the absence of clear imaging criteria for choroid plexus hypertrophy and the inability to assess CSF production non-invasively. As a result, many CPH patients are initially treated with a ventriculoperitoneal (VP) shunt, but subsequently require additional surgical intervention due to intractable ascites. In our study, we encountered two CPH patients who presented with significantly enlarged subarachnoid spaces, reduced parenchymal volume, and prominent choroid plexus. Initially, we treated these patients with a VP shunt, but eventually opted for endoscopic choroid plexus cauterization (CPC) to address the intractable ascites. Following the treatment with endoscopic CPC, we observed a gradual reduction in subarachnoid spaces and an increase in parenchymal volume. In cases where bilateral prominent choroid plexus, markedly enlarged subarachnoid spaces, and cortical atrophy are present, CPH should be suspected. In these cases, considering initial treatment with combined endoscopic CPC and shunt may help minimize the need for multiple surgical interventions.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.220-225
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• 1998

Background: The patients of facial hyperhidrosis have been known that they had much difficulties in interpersonal relationships and social activities due to excessive hidrosis when they were in stress, hot weather, or having meals. Previous drug therapy and stellate ganglion block have only temporary effects. The surgical method, $T_1$ sympathetomy has the risk of Hornor's syndrome. For that reasons, the sympathicotomy of proximal and distal portions of $T_2$ sympathetic ganglion with electroresectoscope used in transurethral resection seemed to be appropriate procedure, and we would like to report the results of our procedure. Method: Under the general anesthesia with semi-sitting position, and the portal was made through the small incision along the upper border of the 4th rib at the crossing point of mid-axillary line. After the partial collapse of lung by insufflation of 300 to 500 ml of $CO_2$, $T_2$ sympathetic ganglion was identified and resected proximally and distally with electro-cauterization. Finally the lung was expanded by limiting flow until the airway pressure reached 30 to 40 cm$H_2O$, and the wound was closed after removal of electroresectoscope. Result: There was no postoperative complication requiring surgical interventions. The facial sweating was stopped immediately after the operation and all the patients appeared to be satisfied. Conclusion: $T_2$ sympathicotomy with TUR electroresectoscope is thought be the minimal invasive and highly successful method in the treatment of facial hyperhidrosis. But longer terms follow-up will be needed to prove this result.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.2
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• pp.140-144
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• 2003

Ameloblastoma is cytologically a benign tumor, but is clinically characterized by infiltrative growth and high recurrency. The criteria for surgical treatment of ameloblastoma has not yet established and it is generally accepted that ameloblastoma be treated differently based on clinical types. The purpose of this paper is to consider effectiveness of enucleation in large-sized intraosseous ameloblastoma that has treated more frequently by radical treatment. 39 cases of the intraosseous ameloblastomas were treated by enucleation in the department of oral and maxillofacial surgery of Yonsei University, dental college from February 1990 to January 2001. 25 cases were selected because they were large in size that could produce facial disfigurement or pathologic fracture of jaws. They were radiographically characterized by the cortical bone that was expanded or eroded locally and histopathologically by 19 solid ameloblastomas and 6 intramural type of unicystic ameloblastomas. Among the 25 cases, 4 cases - 3 solid ameloblastomas and 1 intramural type of ameloblastoma - recurred. Recurrence rate was 16%. The compact bone which is not invaded by ameloblastoma was used as surgical margin of enucleation with accompanying chemical cauterization for killing the residual tumor cells. This may have been the reason for the low recurrence rate. So, it is considered that enucleation and long-term follow-up enable the large-sized intraosseous ameloblastomas that were characterized by almost destroyed cancellous bone and expanded or discontinued cortical bone to treat minimizing facial disfigurement and masticatory dysfunction and sociopsychological impact produced by radical treatment. I recommend that the large-sized intraosseous ameloblastomas without involvement to the surrounding soft tissues be first treated by enucleation.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.66-68
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• 2008

Recently, devices using radiofrequency energy have been developed for arthroscopic soft tissue ablation, cauterization and shrinkage. After ACL reconstruction operation, articular metallic foreign body was found in the post-operative radiographs. It was proven to be the tip of bipolar radiofrequency system after foreign body removal. After that we experienced 2 more cases during the acromioplasty procedure. We requires attention to prevent the separation of the tip from the body in the arthroscopic surgery using bipolar radiofrequency system.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.177-184
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• 1991

A giant cell granuloma and a cementifying fibroma occurring in the same lesion of right mandibular body in a 10 year old boy is presented with a 12 month follow up without recurrence or any other complications after operation. The relatively small lesion of cementifying fibroma was well delineated from the larger lesion of central giant cell granuloma, and as their origins are different each other(odontogenic or connective tissue origin), we have considered that both lesions had developed independently. Clinically, the evidencesa of aggressiveness of giant cell granuloma were also found, that is, large size, earlier age of 10, root resorption of lower right 1st annd 2nd molars and cortical perforation. With curettage and electric cauterization, we have treated both lesions satisfactorily.

• Korean Journal of Head & Neck Oncology
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• v.30 no.2
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• pp.100-103
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• 2014

경부 염증을 주 증상으로 하는 이상와 누공의 치료로써, 전통적으로 외과적 절제술이 주로 시행되었으나, 근래에 들어서는 수술 관련 위험성이 적은 삼염화아세트산 소작술이 선호되고 있다. 본원에서, 2004년 5월부터 2013년 3월까지 컷 다운 튜브를 이용한 삼염화아세트산 소작술을 통해 이상와 누공을 치료한 5명 환자의 증례를 보고한다. 이전까지의 삼염화아세트산 소작술에서, 여러 도구를 이용해 누공의 입구만을 막는 시도를 했던 것과는 달리, 본 증례에서는, 컷 다운 튜브를 이용해 20~50%의 삼염화아세트산을 누공로에 주입함으로써, 이상와 누공 전장을 폐쇄하고자 하였다. 3명의 환자에서는 추적 관찰 중 재발 소견 없었으며, 2명의 환자는 추적 관찰 기간 중 재발하여 삼염화아세트산 소작술을 재시행하였다. 모든 증례에서 부작용 및 합병증은 발생하지 않았다.

• Applied Microscopy
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• v.44 no.1
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• pp.21-29
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• 2014

Retinal glial responses to hypertensive glaucomatous injury were spatiotemporally surveyed. Retinas as a whole or vertical sections were processed for anti-glial fibrillary acidic protein (GFAP), anti-Iba1, anti-nerve growth factor (NGF), and anti-tumor necrosis factor (TNF)-${\alpha}$ immunohistochemistry for confocal microscopic analyses. The optic nerve head of paired controls was processed for electron microscopy. GFAP positive astrocytes appeared in the nerve fiber layer in the glaucomatous and control retinas, changing from fine protoplasmic to stout fibrous parallel to glaucomatous duration. Iba1 positive microglia appeared in both retinas, and enormous reaction appeared at the latest glaucomatous. M$\ddot{u}$ller reaction detected by GFAP reactivity expanded from the end feet to whole profile following to duration in the glaucomatous. NGF reactivity expended from the end feet to the proximal radial processes of the M$\ddot{u}$ller cells in both retinas according to glaucomatous duration. TNF-${\alpha}$ immunoreactivity in the nerve fiber layer was stronger in both the glaucomatous and controls than in the normal, and exceptionally at the latest glaucomatous was even lower than the normal. The astrocytes in the optic nerve head are interconnected with each other via gap junction. These results demonstrate that astrocyte reaction propagates to the contralateral via physical links, and TNF-${\alpha}$ is correlated with NGF production for neuroprotection in response to hypertensive glaucomatous injury.