• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.129-131
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• 2011

Purpose: The purpose of this report is to present a case of persistent parotid fistula treated successfully with preoperative botulinum toxin type A injection into the parotid parenchyma, followed by fistulectomy. Methods: A 72-year-old female patient presented to the hospital with a 5-month history of clear, watery discharge from a tiny opening on the left cheek, which increased during food intake. A chemistry test of the fluid revealed an high amylase level. An ultrasonography of left parotid gland showed a $1.13{\times}0.6cm$ sized fistula. After demarcating the left parotid gland with assistance of ultrasonography, a total 40 units of botulinum toxin type A (Botox, Allergan, Irvine, CA) was injected into 4 subdivisions of the left parotid gland. The clear serous discharge ceased completely on the 5th day after botulinum toxin injection. On the 7th day, a fistulectomy was performed under the local anesthesia. Results: The parotid fistula healed completely without complications. During the 6-month follow up period, there was no discharge from the cheek. Conclusion: On the basis of our experience with type A botulinum toxin as a local anticholinergic agent in treating parotid fistula, preoperative botulinum toxin A injection seems to be very useful to prevent recurrence after fistulectomy.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.40-44
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• 2018

Background: Pregabalin has been studied as a single or multimodal analgesic drug for postoperative pain management in different types of surgeries. We evaluated the analgesic effect of 150 mg of pregabalin in resolving post-gastrectomy pain. Methods: Forty-four patients were randomized into two groups: a pregabalin group that received oral pregabalin (150 mg) 2 h before anesthetic induction, and a control group that received placebo tablets at the same time. Data on postoperative pain intensity (visual analog scale [VAS], at 30 min, 2 h, 4 h, and 24 h), consumption of fentanyl in patient-controlled analgesia (PCA), and the proportion of patients requiring rescue analgesics at different time intervals (0-2 h, 2-4 h, and 4-24 h) were collected during the 24 h postoperative period. Results: The VAS scores did not show significant differences at any time point and consumption of fentanyl in PCA and the proportion of patients requiring rescue analgesics did not differ between the two groups. The groups did not differ in the occurrence of dizziness, sedation, and dry mouth. Conclusion: A preoperative 150 mg dose of pregabalin exerts no effect on acute pain after gastrectomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.4.1-4.4
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• 2020

Background: Odontogenic cysts associated with lower third molar are common. The prognosis for surgical treatment is relatively good. However, postoperative infection discourages the clinicians. Hence, we would like to investigate the factors associated with infection after surgical treatment of cysts associated with the mandibular third molar. Methods: We retrospectively reviewed the medical and radiographic records of 81 patients who were diagnosed with dentigerous cyst or odontogenic keratocyst and underwent cyst enucleation. The factors affecting postoperative infection were divided into host factor, treatment factor, and cystic lesion factor. To identify the factors associated with postoperative infection, we attempted to find out the variables with significant differences between the groups with and without infection. Results: A total of 81 patients (64 male and 17 female) were enrolled in this study. There was no statistical relationship about the postoperative infection between all variables (gender, smoking, diabetes mellitus, age, bone grafting, related tooth extraction, previous marsupialization or decompression, type of antibiotics, cortical perforation associated with cystic lesion, preoperative infection, preoperative cyst size). Conclusions: The results of this study suggest that it is not necessary to avoid bone grafts that are concerned about postoperative infection.

• Acute and Critical Care
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• 제33권4호
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• pp.271-275
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• 2018

We experienced a case of severe intraoperative hyperkalemia during laparoscopic radical nephrectomy in a 60-year-old male patient with renal insufficiency, whose hypertension had been managed by preoperative angiotensin II receptor blocker (ARB) and adrenergic beta-antagonist. After renal vessel ligation, his intraoperative potassium concentration suddenly increased to 7.0 mEq/L, but his electrocardiography (ECG) did not show any significant change. While preoperative ARB therapy has been regarded as a contributing factor for further aggravation of underlying renal insufficiency, we assumed that nephrectomy itself and rhabdomyolysis caused by surgical trauma also aggravated the underlying renal dysfunction and resulted in sudden hyperkalemia. Hyperkalemia was managed successfully with calcium gluconate, insulin, furosemide and crystalloid loading during the intraoperative and immediate postoperative periods, and potassium concentration decreased to 5.0 mEq/L at 8 hours after the operation. The patient's hospital course was uncomplicated, but his renal function deteriorated further.

• Journal of Yeungnam Medical Science
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• 제36권2호
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• pp.136-140
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• 2019

Background: Epidermal cysts are the most common benign epithelial tumors in humans. The curative treatment of epidermal cyst is surgical excision. However, only few studies have investigated the cause and mechanism of postoperative complications of epidermal cysts. Therefore, this study aimed to evaluate the factors affecting complications of epidermal cyst after surgical treatment. Methods: Patients with histologically diagnosed epidermal cysts were selected from among 98 consecutive patients with excised benign cystic tumors from March 2014 to August 2017. Sex, age, size, mobility, site of occurrence, history of infection, history of incision and drainage, complications, history of reoperation, and method of overcoming complications was obtained by analyzing medical records retrospectively. Results: Five of the 98 patients had wound dehiscence due to surgical infection. Three of them underwent wound healing with conservative treatment without a second operation. The other two patients underwent a second operation and showed signs of preoperative infection. None of the factors showed statistical significance in relation to the occurrence of complications. Conclusion: Postoperative complications occurred when the excision of the epidermal cyst was performed at preoperative infection sites or at sites with high tension, so attention should be paid to postoperative care.

• Clinics in Shoulder and Elbow
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• 제24권1호
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• pp.15-20
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• 2021

Background: The presence of an acromial spur implies a rotator cuff disorder due to impingement between the acromial spur and the rotator cuff. The purpose of the study was to observe acromial spurs using ultrasonography and to compare measurements between plain radiographs and sonograms. Methods: We retrospectively enrolled 51 consecutive patients with acromial spurs, which were interpreted on preoperative plain radiographs (supraspinatus outlet view and 30° caudal tilt) and preoperative sonograms. The ultrasonography transducer was held vertically and continuously moved laterally, which corresponded to the long axis of the long head of the biceps. The distance from the most distal margin of the original acromion to the most projected point of the acromial spur was measured. Results: No significant difference was found between the plain radiograph and ultrasonography measurements (p=0.186). A moderate to strong correlation was detected between the ultrasonography and supraspinatus outlet-view measurements (r=0.776, p=0.000). Conclusions: Anteriorly projected acromial spurs were well-visualized by ultrasonography. No discrepancy in acromial spur length was detected between the use of plain radiography (supraspinatus outlet view and 30° caudal-tilt view) and ultrasonography. The correlation coefficients between the plain radiography and ultrasonography measurements exceeded 0.7.

• Journal of Gastric Cancer
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• 제21권1호
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• pp.4-15
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• 2021

Recently, endoscopic screening systems have enabled the diagnosis of gastric cancer in the early stages. Early gastric cancer (EGC) is typically characterized by a shallow invasion depth and small size, which can hinder localization of EGC tumors during laparoscopic surgery. Here, we review nine recently reported tumor localization methods for the laparoscopic resection of EGCs. Preoperative dye or blood tattooing has the disadvantage of spreading. Preoperative 3-dimensional computed tomography reconstruction is not performed in real time during laparoscopic gastrectomy. Thus, they are considered to have a low accuracy. Intraoperative portable abdominal radiography and intraoperative laparoscopic ultrasonography methods can provide real-time feedback, but these methods require expertise, and it can be difficult to define the clips in some gastric regions. Despite a few limitations, intraoperative gastrofibroscopy provides real-time feedback with high accuracy. The detection system using an endoscopic magnetic marking clip, fluorescent clip, and radio-frequency identification detection system clip is considered highly accurate and provides real-time feedback; we expect a commercial version of this setup to be available in the near future. However, there is not yet an easy method for accurate real-time detection. We hope that improved devices will soon be developed and used in clinical settings.

• Archives of Plastic Surgery
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• 제50권2호
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• pp.153-155
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• 2023

The vascular anatomy of the deep inferior epigastric artery perforator (DIEP) flap has been well studied in the planning for autologous breast reconstruction. Preoperative imaging with computed tomography angiography (CTA) provides accurate assessment of this vascular anatomy, which varies widely across patients. Several papers to date have described their encounter with an anomalous "epiperitoneal" or "peritoneo-cutaneous" perforator during flap harvest, a perforator that pierces the posterior rectus sheath from a peritoneal origin, to traverse rectus abdominis and supply the DIEP flap integument. In the course of over 3,000 CTA assessments of the vascular anatomy of the abdominal wall, we have encountered dominant peritoneo-cutaneous perforators in 1% of cases, and smaller perforators seen in many more cases, approaching 5% of cases. With increasing sensitivity of imaging, we also describe a unique case of multiple large bilateral peritoneo-cutaneous perforators, and present these findings in the context of DIEP flap harvest. It is critical to recognize these peritoneo-cutaneous perforators preoperatively to avoid mistaking them for a DIEP during the raising of a DIEP flap. The routine use of preoperative CTA enables the safe identification of individual vascular anatomy, including significant peritoneo-cutaneous perforators.

• Journal of Audiology & Otology
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• 제23권3호
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• pp.140-144
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• 2019

Background and Objectives: Inlay butterfly cartilage tympanoplasty makes the graft easy, and reduces operating time. The present study aimed to investigate the outcomes of microscopic versus endoscopic inlay butterfly cartilage tympanoplasty. Subjects and Methods: In this retrospective study, the outcomes of 63 patients who underwent inlay butterfly cartilage tympanoplasty with small to medium chronic tympanic membrane perforation were evaluated. Twenty-four patients underwent conventional microscopic tympanoplasty and 39 underwent endoscopic tympanoplasty. The outcomes were analyzed in terms of the hearing gain and graft success rate. Results: The surgical success rate was 95.8% in the patients who underwent conventional microscopic tympanoplasty and 92.3% in those who underwent endoscopic tympanoplasty. In both groups of patients, the postoperative air-bone gap (ABG) was significantly lower than the preoperative ABG. There were no significant differences between the preoperative and postoperative ABG values in either group. Conclusions: Endoscopic inlay tympanoplasty using the butterfly cartilage technique appears to be an effective alternative to microscopic tympanoplasty and results in excellent hearing.

• 동서간호학연구지
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• 제16권1호
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• pp.44-52
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• 2010

Purpose: The study examined the effects of preoperative patient controlled analgesia (PCA) education on postoperative pain, knowledge of PCA, and attitude toward pain medication. Methods: The participants were patients who underwent surgery in H University Hospital,and were assigned to PCA group (experiment group, n=30) or the control group (n=30). Results: Knowledge of PCA and positive attitude toward pain medication were higher in the experiment group than in the control group. Postoperative pain scores in the experiment group were significantly lower than those in the control group at 48 and 72 hr after surgery, but there was no significant difference at 24 hr after surgery. The experiment group had more positive attitudes on the medication than the control group. Conclusions: Preoperative PCA education could be an effective nursing intervention for pain management of patients after surgery.