• 대한두개안면성형외과학회지
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• 제22권3호
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• pp.168-172
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• 2021

Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

• 한국임상수의학회지
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• 제38권3호
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• pp.147-151
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• 2021

A 5-year-old castrated male Maine Coon cat presented with chronic otitis on the right ear. The clinical signs, scratching and head shaking, were recurrent despite symptomatic treatment, including antibiotics and antifungal agents. Video otoscopic examination and computed tomography (CT) examination revealed a polyp in the right ear canal. The polyp was removed via per-endoscopic trans-tympanic traction (PTT) with a grasping forceps. After treatment, Horner's syndrome occurred in the right eye but spontaneously resolved a week later. The mass was diagnosed as inflammatory polyp with a fibrovascular stroma containing plasma cells, lymphocytes, and neutrophils. All clinical signs were improved, and no recurrence was observed after 3 weeks of follow-up. This case report demonstrates that CT scan is effective in identifying the margin of polyp and PTT technique is non-invasive method for treating inflammatory polyp in cats without severe complications.

• Journal of Chest Surgery
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• 제54권3호
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• pp.206-213
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• 2021

Background: Tracheoesophageal fistula (TEFs) is a rare condition that requires complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the literature and at Pusan National University Yangsan Hospital using standardized techniques. Methods: This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. The surgical method was determined based on the size of the fistula observed within the endoscope. Results: TEF occurred in 7 patients (87.5%) after intubation or tracheostomy and in 1 patient (12.5%) after esophageal surgery due to conduit necrosis. For tracheal management, 5 and 2 patients underwent tracheal resection and end-to-end anastomosis and primary repair, respectively. The median length of resection was 2.5 cm (range, 1.3-3.4 cm). For esophageal management, 6 patients underwent primary repair and 1 patient underwent esophageal diversion. One patient underwent TEF division with a stapler. Interposition of a muscle flap was performed in 2 patients. TEF recurrence, esophageal stenosis, and dehiscence or granulation occurred in 1, 1, and 2 patients, respectively. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. Conclusion: Although TEF surgery is complex and challenging, good results can be achieved if surgical standards are established and experience is accumulated.

• Clinical Endoscopy
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• 제56권6호
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• pp.716-725
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• 2023

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. For example, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical practice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE) with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of larger accessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the development in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the challenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as perforation, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regarding SBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated with ERCP.

• 디지털콘텐츠학회 논문지
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• 제12권2호
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• pp.151-156
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• 2011

CT검사 후 재구성 영상 처리 기법인 Ray-sum 기법과 Shaded Surface Display(이하 SSD)기법을 분석 및 영상평가를 하여 위암 환자의 입체적인 정보 제공의 유용성 여부를 확인하고자 하였다. 위암환자 20명을 대상으로 64-MDCT를 이용하여 raw data(원시데이터)를 획득한 후 영상 재구성 처리를 하였다. 분석 결과 Ray-sum과 SSD재구성 영상모두 해부학적 구조를 정확히 묘사하는 것으로 평가 받았고, 영상의 정확도 평가에서 Ray-sum, SSD재구성 영상 대부분에서 병변의 위치가 위장 내시경과 일치하였으며 6cm이상에서 오차가 더 있음을 알 수 있었다. 또한 병변에 대한 영상판독결과와 내시경 및 병리학적 소견의 일치도가 높음을 알 수 있었다.

• 한국컴퓨터산업학회논문지
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• 제8권1호
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• pp.49-56
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• 2007

빔의 열적효과는 세포조직의 서로 다른 구성성분과 레이저 빔의 서로 다른 파장에서 다른결과를 나타내며 세포조직에서 온도증가는 먼저 응고가 이루어지고, 절단이나 탄화과정이 일어나며 $300^{\circ}$이상에서는 세포조직의 파괴에 의한 증발이 발생하게 된다. $CO_2$ 레이저는 최소한 조직손상으로 이러한 효과를 얻는데 최적이라고 보며 0.1mm의 최소한의 세포조직 깊이에서 일어나는 효과의 근본적인 장점은 생체조직이나 내장기관에 안정적이다. $CO_2$레이저사용에 있어서 단점은 무엇보다도 세포파괴에서 생성되는 입자들의 부품흡착 등으로 결과적으로 레이저의 출력감소가 일어나는데, 영 전압, 영 전류 스위칭 포워드 컨버터를 도입하여 기존의 하드 스위칭 포워드 컨버터에 있어서 Turn-off, on시 발생되는 스위칭 방식을, 적용함으로써 1차 측 스위칭 소자의 Turn-off, on시 영전압, 영전류 스위칭을 이루어 정밀도가 요구되는 산부인과용 $CO_2$ 연속 형 레이저의 고압출력 모듈에 따른 펄스 트랜스의 안정화에 필수적으로 기여하며, 레이저 출력과 안정화가 되도록 설계 및 제작한 결과, 기존제품보다 향상된 결과를 가져왔다. 추후 시스템적으로 보완을 하면 우수한 결과가 될 것으로 사려된다.

• Journal of Animal Science and Technology
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• 제59권3호
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• pp.5.1-5.10
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• 2017

Background: Bovine respiratory disease (BRD) is one of the leading causes of economic losses in the beef and dairy industry. Reliable antemortem tools for diagnosing BRD would improve the efficacy of treatment and reduce costs. Here we examined whether the relatively simple technique of thoracoscopy can support BRD diagnosis under field conditions. We also compared various equipment set-ups in order to optimize the safety and efficacy of the procedure. A total of 24 thoracoscopic procedures were performed in 17 calves diagnosed with BRD and in 2 healthy control calves. Rigid and flexible endoscopes and industrial videoscopes were tested using various insertion approaches. The suitability of the technique was assessed in terms of duration, volume of air extracted, visualization score, and image quality. Safety was assessed in terms of rectal temperature, body weight, breaths/min, presence of fibrinogen, pain score, recovery time, intraoperative complications and risk of laceration or threatening collapse. Results: Insertion of a flexible endoscope via a right, dorso-caudal approach at the $5^{th}$ intercostal space allowed complete examination of the right lung in 15 min, as well as identification of main lung lesions and adherences in calves with BRD, without compromising calf welfare. While the dorso-caudal approach was optimal, it was associated with substantial discomfort when rigid endoscopes were used, minimal complications or mortality due to thoracoscopy were observed up to 28 days after the procedure. Videoscopes were as safe and easy to use as endoscopes, but endoscopes provided better image quality. Conclusion: This study provides the first field evidence that thoracoscopy can be safe to explore BRD-diseased calves. These results justify a larger study to rigorously assess the diagnostic performance of the technique.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.613-618
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• 2010

Purpose: The coronal approach for repair of frontal sinus fractures is associated with significant adverse sequelae including a long scar, alopecia, paresthesias, and, uncommonly, facial nerve injury. To minimize these complications, an endoscopic approach for repair of frontal sinus fractures was developed. The authors now present the results of an endoscopy-assisted approach for the treatment of frontal sinus fractures. Methods: From 2002 to 2009, five patients with frontal sinus fracture underwent endoscopic repair. Two slit incisions were placed in the scalp, and one or two stab incisions directly over the fractures were placed in the forehead. After subperiosteal dissection, fracture segments were reduced under direct vision and fixed with microplates or fibrin glue. Results: All patients had good cosmetic results and remained free of sinus complaints. There were no perioperative complications reported. Conclusion: Endoscopic repair of frontal sinus fractures is an efficacious technique that significantly reduces patient morbidity. A relatively wide range of anterior table fractures can be reduced using an endoscope. In cases of complicated comminuted fractures, fibrin glue helps to achieve satisfactory endoscopic reduction. Endoscopic repair is an alternative treatment for various anterior table fractures of the frontal sinus.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권5호
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• pp.474-481
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• 2006

The endoscopic assisted approach for the treatment of condylar fracture is a less invasive alternative treatment modality and is considered to be able to overcome the limited access to the operation field to obtain an accurate reduction and fixation. Six patients with condylar neck and subcondylar fracture underwent the endoscopic assisted open reduction and internal fixation through the transoral approach at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The endoscope was inserted through an intraoral incision and the reduction of fracture fragment was performed via a transbuccal approach with two transcutaneous stab incisions. Five patients showed anatomic reduction without any complications. One patient, whose fracture site was fixed with a single plate, showed displacement of fractured condylar segment during the follow up period. No patient had any facial nerve damage.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.249-254
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• 2000

Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.