• Title/Summary/Keyword: hiatus

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Case report of the management of the ranula

  • Choi, Moon-Gi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.357-363
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    • 2019
  • Ranula is a mucocele caused by extravasation of the sublingual gland on the floor of the mouth. The most common presentation is a cystic mass in the floor of the mouth. A portion of the sublingual gland could herniate through the mylohyoid muscle, and its extravasated mucin can spread along this hiatus into submandibular and submental spaces and cause cervical swelling. This phenomenon is called plunging ranula. A variety of treatments for ranula has been suggested and include aspiration of cystic fluid, sclerotherapy, marsupialization, incision and drainage, ranula excision only, and excision of the sublingual gland with or without ranula. Those various treatments have shown diverse results. Most surgeons agree that removal of the sublingual gland is necessary in oral and plunging ranula. Four patients with ranula were investigated retrospectively, and treatment methods based on literature review were attempted.

Sliding esophageal hernia associated with hemorrhagic gastric ulcer-A case report- (출혈성 위궤양이 병발한 식도열공 허니아의 치험례)

  • 정원상
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.386-390
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    • 1983
  • One case of surgically treated sliding esophageal hiatal hernia associated with bleeding gastric ulcer is presented. The patient was 73 years-old woman who had suffered from epigastric heartburn, indigestion, and melena since 3 months prior to admission. Esophageal hiatal hernia was suspected on the simple chest film and the diagnosis was confirmed by tetralogic barium study of the gastrointestinal tract. Hematemesis and melena were persisted so emergent thoracotomy and abdominal exploration were undertaken. Repair of hiatal hernia by constricting suture around relaxed esophageal hiatus was made and plication sutures were Inserted between esophagogastric junction and median arcuate ligament of diaphragm. Concomittently, subtotal gastrectomy with Billroth II procedure was performed to removal of large bleeding ulcer on the lesser curvature of the stomach antrum. Postoperative course was uneventful.

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Morphometric Analysis of Distances between Sacral Hiatus and Conus Medullaris Using Magnetic Resonance Image in Korean Adult (자기공명영상을 이용한 한국 성인의 엉치뼈틈새와 척수원뿔 사이 거리 연구)

  • Park, Tai Soo;Hwang, Byeong-Wook;Park, Sang-Joon;Baek, Sun-Yong;Yoon, Sik
    • Anatomy & Biological Anthropology
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    • v.29 no.4
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    • pp.145-154
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    • 2016
  • The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.

An Analysis of the Surface Anatomical Location of the Posterior-inferior Margin of the Sacroiliac Joint (천장관절 후하연의 표면해부학적 위치 분석)

  • Cho, Kwang Yeon;Kim, Bum Su;Kim, Won Oak;Yoon, Duck Mi;Yoon, Kyung Bong
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.47-51
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    • 2009
  • Background: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. Methods: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. Results: The oblique angle was $5.4{\pm}2.9^{\circ}$. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were $3.8{\pm}0.8cm$ and $0.9{\pm}0.6cm$, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were $3.4{\pm}0.7cm$ and $3.9{\pm}0.6cm$, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). Conclusions: The measurements in this study can be used as a reference standards for the blind SIJ block.

A Case of Hutch's Diverticulum Associated with Severe Bilateral Vesicoureteral Reflux (심한 방광 요관 역류를 동반한 양측성 Hutch's Diverticulum 1례)

  • Shin Jong-Su;Jeon Yu-Sik;Ra Chang-Soo;Jeong Gun-Young;Yeum Gyu-Young
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.86-89
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    • 1998
  • A bladder diverticulum occurs when the bladder mucosa herniates or protrudes through the muscular wall of the baldder. The majority of congenital bladder diverticula occurs in males. They are the most common in the region of the bladder base, most frequently in the region of the ureteral hiatus, in which case they are known as Hutch's diverticula. They can give rise to obstruction or reflux. We had experienced a case of bilateral Hutch's diverticulum associated with vesicoureterai reflux in a 23 month old male. Chief complaints were urinary frequency and dysuria. Voiding cystourogram and CT scan revealed large bilateral Hutch's diverticulum with bilateral vesiciureteral reflux grade VI. There was evidence of urinary infection. This patient was successfully treated by ureteroneocystostomy. We report this case with a brief review of related literatures.

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Facial Nerve Decompression via Middle Fossa Approach : Report of Three Cases (말초성 안면마비에서 중두개와 접근법에 의한 안면신경 감압술 : 3례 보고)

  • Cho, Joon;Park, Sung-Ho;Kim, Jae-Young
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.479-485
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    • 2001
  • Objective : Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. Method : Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus. Results : After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially. Conclusion : This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

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Event date model: a robust Bayesian tool for chronology building

  • Philippe, Lanos;Anne, Philippe
    • Communications for Statistical Applications and Methods
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    • v.25 no.2
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    • pp.131-157
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    • 2018
  • We propose a robust event date model to estimate the date of a target event by a combination of individual dates obtained from archaeological artifacts assumed to be contemporaneous. These dates are affected by errors of different types: laboratory and calibration curve errors, irreducible errors related to contaminations, and taphonomic disturbances, hence the possible presence of outliers. Modeling based on a hierarchical Bayesian statistical approach provides a simple way to automatically penalize outlying data without having to remove them from the dataset. Prior information on individual irreducible errors is introduced using a uniform shrinkage density with minimal assumptions about Bayesian parameters. We show that the event date model is more robust than models implemented in BCal or OxCal, although it generally yields less precise credibility intervals. The model is extended in the case of stratigraphic sequences that involve several events with temporal order constraints (relative dating), or with duration, hiatus constraints. Calculations are based on Markov chain Monte Carlo (MCMC) numerical techniques and can be performed using ChronoModel software which is freeware, open source and cross-platform. Features of the software are presented in Vibet et al. (ChronoModel v1.5 user's manual, 2016). We finally compare our prior on event dates implemented in the ChronoModel with the prior in BCal and OxCal which involves supplementary parameters defined as boundaries to phases or sequences.

Esophageal Replacement with Transhiatal Gastric Transposition In the Long Gap Esophageal Atresia - Report of Two Cases - (원간격결손 식도페쇄증에서 경열공적 위전위법을 이용한 식도재건술)

  • Han, Seok-Joo;Kim, Sung-Do;Kim, Choong-Sai;Oh, Jung-Tak;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.3 no.2
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    • pp.152-159
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    • 1997
  • Transhiatal gastric transposition was performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. A portion of the proximal and the distal esophageal segment were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through the esophageal hiatus and posterior mediastinum. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.

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Surgical Management of Chylothorax Complicating Transhiatal Esophagectomy in Benign Esophageal Stricture (식도 열공을 통한 식도 제거술 시행후 발생한 유미흉의 외과적 치료)

  • 홍종면;노윤우
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.672-674
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    • 1996
  • Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.

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A Case of Chronic Pancreatitis with Massive Pleural Effusion (다량의 늑막 삼출을 동반한 만성 췌장염 1례)

  • Lee, Eun Young;Kang, Yo Han;Kim, Jae Young;Kim, Sung Won
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.81-86
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    • 2005
  • Massive pancreatic pleural effusion is a rare complication of chronic pancreatitis. It results from leakage of pancreatic secretion into the pleural space through the aortic or esophageal hiatus, either by a pancreatic duct disruption or communicating pseudocyst. The presentation of the pancreatic pleural effusion is often misleading as respiratory rather than abdominal symptoms because of predominance of pulmonary complaints. Markedly elevated amylase level of the pleural fluid is highly suggestive of the diagnosis. We experienced a case of chronic pancreatitis with massive pleural effusion in a 9-year-old female, who presented with a 6-months history of intermittent abdominal pain, and cough and chest pain for 3 days.

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