• Archives of Plastic Surgery
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• 제39권6호
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• pp.612-617
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• 2012

Background Packing after closed reduction of a nasal bone fracture causes inconvenient nasal obstruction in patients. We packed the superior meatus with Vaseline gauze to support the nasal bone, and packed the middle nasal meatus with a Doyle Combo Splint consisting of an airway tube, a silastic sheet, and an expandable sponge to reduce the inconvenience. In addition, we aimed to objectively identify whether this method not only enables nasal respiration but also sufficiently supports the reduced nasal bone. Methods Nasal ventilation was measured via spirometry 1 day before surgery and compared to 1 day after surgery. To compare support of the reduced nasal bone by the 2 methods, 2 plastic surgeons assessed the displacementon X-rays taken after the surgery and after removing the packing. The extent of nasal obstruction, dry mouth, sleep disturbance, headache, and swallowing difficulty were compared with visual analog scales (VAS) on a pre-discharge survey. Results In the experimental group, the nasal respiration volume 1 day after surgery remained at $71.3%{\pm}6.84%$ on average compared to 1 day prior to surgery. Support of the reduced bone in the experimental group ($2.80{\pm}0.4$) was not significantly different from the control group ($2.88{\pm}0.33$). The VAS scores for all survey items were lower in the experimental group than in the control group, where a lower score indicated a lower level of inconvenience. Conclusions The nasal cavity packing described here maintained objective measures of nasal respiration and supported the reduced bone similar to conventional methods. Maintaining nasal respiration reduced the inconvenience to patients, which demonstrates that this packing method is useful.

• 대한장애인치과학회지
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• 제7권1호
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• pp.29-32
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• 2011

상부위장관 이물질의 섭취는 대부분 위장관에서 자연적으로 배출되지만, 20% 정도에서는 내시경 또는 수술적 제거의 적응증이 된다. 특히 치과치료중 소아가 삼킬 수 있는 여러 가지 기구 중 bur 등은 예리하고 길이가 길기 때문에 생리적 협착 부위에서 걸려 자연배출이 힘들 수 있다. 또한시간이 지날수록 식도벽에 고착되고 궤양 등의 합병증을 일으켜 내시경으로 제거하기가 어렵기 때문에 소아가 삼켰을 경우 신속한 대처가 필요하겠다.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.113-117
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• 2009

Purpose: Although Hydrofluoric acid(HF) is not a strong acid when compared to other hydrogen halides, it is a feared corrosive and is particularly dangerous at higher concentrations. HF burns are characterized by symptoms, often delayed and localized with diluted HF solutions, to include erythema, edema and severe pain. Pain, a well known symptom following exposure to calcium binding. And, EMLA$^{(R)}$ cream is a topical formulation based upon the eutectic mixture of lidocaine and prilocaine and is used in clinical settings to provide pain relief undergoing superficial surgical procedures. The aim of this study is to evaluate effects of EMLA$^{(R)}$ cream, pain - control dressing on the treatment for HF injury wound. Methods: From June 2007 to June 2008, this study was carried out with 10 patients who had HF partial thickness burns. We were applied topically EMLA$^{(R)}$ cream to injured wound with vaseline gauze and 10% calcium gluconate wet gauze dressings. As a principle, in the emergency treatment, partial or complete removal of the bullae along with copious washing with normal saline was done, depending on the degree of HF invasion of the distal digital extremities. The effect of dressing was investigated by visual analogue pain scale. Results: We therefore reviewed 10 cases of HF - induced pain and pain relief treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae and EMLA$^{(R)}$ related complications. Conclusion: Proper initial treatment of HF burns are important, if not promptly recognized and properly treated, for produce serious injury. Topical EMLA$^{(R)}$ cream remain a powerful, new advancement for minimizing HF - related pain during dressing procedures. When used appropriately, topical EMLA$^{(R)}$ cream can provide a safe and effective alternative to other forms of HF - pain control treatment.

• Archives of Plastic Surgery
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• 제40권3호
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• pp.259-262
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• 2013

After skin grafting, to prevent hematoma or seroma collection at the graft site, a tie-over dressing has been commonly used. However, although the conventional tie-over dressing by suture is a useful method for securing a graft site, refixation is difficult when repeated tie-over dressing is needed. Therefore, we recommend a redoable tie-over dressing technique with multiple loops threads and connecting silk threads. After the raw surface of each of our cases was covered with a skin graft, multiple loop silk thread attached with nylon at the skin graft margin. We applied the ointment gauze and wet cotton/fluffy gauze over the skin graft, then fixed the dressing by connecting cross-counter multiple loop thread with connecting silk threads. When we opened the tie-over dressing by cutting the connecting silk threads, we repeated the tie-over dressing with the same method. The skin graft was taken successfully without hematoma or seroma collection or any other complications. In conclusion, we report a novel tie-over dressing enabling simple fixation of the dressing to maintain proper tension for wounds that require repetitive fixation. Further, with this reliable method, the skin grafts were well taken.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.233-237
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• 2013

Delayed traumatic intracerebral hemorrhage (DT-ICH) is a rare event in head trauma patients. However, it develops unexpectedly and results in very severe brain damage. Thus, close monitoring of the neurologic status is needed for every trauma patient. Sometimes, however, neurologic monitoring cannot be done because of sedation, especially in cases of abdominal surgery. In this case report, we describe the case of a 37-yr-old, male patients who had hemoperitoneum because of spleen and renal injury. At the initial operation, massive bleeding was found, so gauze-packing surgery was done first. After the first operation, we sedated the patient for about two days, after which the packed gauze was removed, and the abdominal wound was closed. Immediately after the second operation, we found pupil dilation. Emergent CT was performed. The CT revealed DT-ICH with severe brain edema and midline shifting. However, the patient condition deteriorated progressively despite emergency operation, he expired 2 days after hematoma evacuation.

• Archives of Plastic Surgery
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• 제32권1호
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• pp.124-130
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• 2005

In the microsurgical era, replantation with microvascular anastomosis is considered as the most superior method in aspects of texture, color, shape in case of nose amputation. There are some reported cases of replantation in nose amputation historically, but most of them are composite graft cases rather than microvascular anastomosis. Only a few cases of successful nasal replantation with microvascular anastomosis have been reported due to the reason that the size of vessels is usually very small and identifying suitable vessels for anastomosis is difficult. Microanastomosis of artery and microanastomosis of vein are ideal in replantation, but identifying suitable veins is often difficult. Without venous anastomosis, resolving the venous congestion remains to be a problem. We can carry out arteriovenous shunt if we can find two arteries in amputee. However, the smaller the size of amputee is, the more difficult it is to find two arteries. Instead of arteriovenous shunt, we can try external venous drainage(frequently swab, pin-prick, stab incision, IV or local heparin injection, dropping, apply of heparin-soaked gauze, use of medical leech). Here, we present three cases of replantation with microscopical arterial anastomosis (one angular artery, two dorsal nasal arteries) and external venous drainage (stab incision, application of medical leech and heparin-soaked gauze) even though the size of amputee may be as small as $1.5{\times}1.0cm$. In all cases, surgical outcomes were excellent in cosmetic and functional aspects. This report describes successful replantation by microvasular anastomosis in case that suitable veins are not found.

• Journal of Chest Surgery
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• 제40권8호
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• pp.590-592
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• 2007

55세 남자환자가 간헐적인 기침, 피 섞인 가래를 주소로 입원하였다. 35년 전 그는 군대에서 결핵으로 인해 우측 상엽절제술을 받았다. 흉부 컴퓨터 단층촬영에서는 우측폐의 내부에 공기-초승달 징후를 포함하고 있는 종괴가 보였다. 우측상엽에 $5{\times}7\;cm$ 크기의 종괴가 있었고, 경계가 분명하였다. 제거한 종괴를 살펴보니 이물질(거즈)을 포함하고 있었다. 저자들은 아스페르질루스종으로 오진된 폐내 잔존거즈를 체험하였기에 보고하는 바이다.

• 박물관보존과학
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• 제18권
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• pp.35-50
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• 2017

국립중앙박물관 목조불상 조사사업 중 복장물에 직물이 포함된 4건 53점의 조사를 실시하였다. 조사 결과 첫째, 복장직물의 직조 방식을 구분하면 고려시대의 라직물 2점과 능직물 5점이 확인되었으며, 조선시대 특징이 나타나는 단직물과 사직물로 분류되었다. 특히 금동관음보살좌상(덕수801) 복장직물에서는 조선 전기와 후기 특징을 지닌 직물로 분류된 것으로 보아 15세기와 17세기에 2차례에 걸쳐 납입이 이루어졌을 가능성이 높다. 둘째, 직물 무늬의 종류는 꽃무늬와 보배무늬, 과실무늬, 동물이 함께 나타난 식물무늬와 구름무늬로 구성된 자연산수무늬로 구별되었다. 셋째, 복장직물의 수량은 적지만 구성에 따라 모든 방위에 해당될 것으로 추정할 수 있는 직물 편이 발견되었다.

• 대한치과의사협회지
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• 제15권1호
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• pp.27-31
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• 1977

Dentigerous cysts are closed epithelium-lined sacs formed about the crowns of unerupted teeth. Most of them probably are the result of degenerative changes in the reduced enamel epithelium. The authors observed 1 3 year old girl with a swelling and buccal bony expansion of the left mandible. Roentgen examination showed a cystic area in the left side of mandible. Under general anesthesia by means of nasotracheal intubation, intraorally, the operation by enucleation consisted in surgical removal of dentigerous cyst and the left unerupted Ist molar of mandible. The cavity was partially sutured and packed with iodoform gauze. Healing was uneventful.

• 한국임상수의학회지
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• 제13권2호
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• pp.208-211
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• 1996

The left tusk of Asian elephant (Elephas maximus) was splitted longitudinally and its middle portion avulsed by slip. The pulp was exposed and bled. A loosened tusk fragment continued to irritate its sulcus. We performed a partial pulpotomy and pulp capping. We filled the wide space between the loosened tusk fragment and the counterpart with zinc oxide eugenol and zine phophate cement but it was failed, and then we fastened the loosened tusk fragment to the counterpart by gauze and plaster. The ollsened tusk fragment grew to drop 100 days after the insult and main portion with pulp capping was healthy.