• Title/Summary/Keyword: surgical area

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Hemangiopericytoma Recurred at the Distant Area - Case Report - (원격 부위에서 재발한 뇌수막 혈관주위세포종 - 증 례 보 고 -)

  • Park, Joung-Youn;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.528-532
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    • 2001
  • Hemangiopericytomas, which used to be classified as the subtype of the meningiomas, like the angioblastic meningiomas or hemangiopericytic meningiomas, are rare in the central nervous system with an incidence of <1% of all central nervous system(CNS) tumors. In spite of a total surgical removal, hemangiopericytomas have a tendency of high local recurrence and distant metastasis. The authors report a case of hemaniogipericytoma recurred at the remote area from the primary site. The tumor recurred in the meninges of right temporal area after total removal of the tumor in the right parasaggital region including the falx.

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Basal cell carcinoma and squamous cell carcinoma in a single tumor in the anterior auricular area

  • Lee, Il Seok;Hong, In Pyo;Lee, Hye Kyeong
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.257-260
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    • 2020
  • The concurrence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in a single tumor is rarely encountered. We report a case of BCC and SCC in a single tumor in the anterior auricular area. A 70-year-old woman had been diagnosed with BCC by a punch biopsy performed at a dermatology clinic. We performed wide excision of the tumor with an ulcer in the anterior auricular area. Analysis of the biopsy specimen revealed the presence of both BCC and SCC in the tumor. This case illustrates that it is necessary to establish a precise diagnosis and formulate appropriate surgical and treatment plans considering the possibility that two carcinomas may coexist, although the possibility is low in patients with skin cancer.

Treatment of osteomyelitis in the rear area of the lingula of the mandible using sagittal split ramus osteotomy: a case report

  • Jung, Tae-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.4
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    • pp.203-207
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    • 2015
  • Osteomyelitis is classified into three groups according to its origin: osteomyelitis that originates from the blood supply, osteomyelitis related to bone disease or vascular disease, and osteomyelitis related to a local infection of dental or non-dental origin. The present case involved osteomyelitis related to a local infection of dental origin and was located in the rear area of the lingula of the mandible. We decided to use sagittal split ramus osteotomy to access the osteomyelitis area. Under general anesthesia, we successfully performed surgical sequestrectomy and curettage via sagittal split ramus osteotomy.

ERUPTING GUIDANCE OF IMPACTED MAXILLARY PERMANENT INCISOR WITH APICALLY REPOSITIONED FLAP (근단 변위 판막술을 이용한 상악 영구 절치의 맹출 유도)

  • Im, Ye-Jin;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.512-518
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    • 2010
  • The impaction of the maxillary permanent incisor is a common clinical problem and is mostly found at the "labial to the alveolar process." Surgical exposure and orthodontic treatment with fixed orthodontic appliances can be considered if normal eruption of the labillay impacted tooth is not expected. Surgical exposure of the impacted tooth, that is usually under the attached gingiva or is surrounded by alveolar bone through gingivectomy and removal of alveolar bone, may give a rise to complications such as diminution in the width of the attached gingiva, inflammation of the gingiva, and the loss of marginal alveolar bone. Therefore, closed eruption technique, which includes surgical exposure and orthodontic treatment with fixed orthodontic appliances followed by repositioning of surgical flap, is preferred. However, apically repositioned flap of the impacted tooth, which is beneath the movable submucosal area or is above the alveolar crestal area, can prevent unwanted exposures and facilitate successful tooth eruption. In this report, we described esthetic results of three patients with unerupted maxillary permanent incisor who were performed with an apically positioned flap without the loss of attached gingiva.

Follow-Up of Residual Shunt after Repair of Ventricular Septal Defect (심실중격결손 봉합 후 잔류 단락의 추적관찰)

  • 정태은;이장훈;김도형;백종현;이동협;이정철;한승세;이영환
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.580-583
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    • 2002
  • Background: Obtaining precise hemodynamic and morphological information in the early postoperative period after surgical correction of congenital heart disease is important in determining the need for future medical or surgical intervention. We investigated the residual shunting after surgical repair of simple ventricular septal defect in order to know the incidence of residual shunting in the postoperative period and the natural history of small residual shunts located in the peripatch area. Material and Method: Forty three consecutive patients under one year of age who underwent patch repair of a simple ventricular septal defect were evaluated for incidence of residual shunts by echocardiography. Result: Eleven patients had echocardiographic residual shunt in the peripatch area at immediate postoperative period, however, there were no patients who needed reoperation due to deteriorated hemodynamic effect of residual shunt. The incidence of residual shunts was not significantly different with type of ventricular septal defect and material used for closure. During follow up period, two patients were lost and remaining nine patients no longer showed evidence of residual shunt. The mean time of last evidence of shunt was $4.2{\pm}3.6$ months after operation. Conclusion: Residual peripatch shunt flow was frequently noted in the immediate postoperative period following surgical repair of ventricular septal defect, however, most of them were disappeared within six months.

Surgical Strategy of Epilepsy Arising from Parietal and Occipital Lobes (두정엽 및 후두엽 간질에 대한 수술전략)

  • Sim, Byung-Su;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.222-230
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    • 2000
  • Purpose : Resection of the epileptogenic zone in the parietal and occipital lobes may be relevant although only few studies have been reported. Methods : Eight patients with parietal epilepsy and nine patients with occipital epilepsy were included for this study. Preoperatively, all had video-EEG monitoring with extracranial electrodes, MRI, 3D-surface rendering of MRI using Allegro(ISG Technologies Inc., Toronto, Canada), and PET scans. Sixteen patients underwent invasive recording with subdural grid. Eight had parietal resection including the sensory cortex in two. Seven had partial occipital resection. Two underwent total unilateral occipital lobectomy. The extent of the resection was made based mainly on the data of invasive EEG recordings, MRI, and 3D-surface rendering of MRI, not on the intraoperative electrocorticographic findings as usually done. During resection, electrocortical stimulation was performed on the motor cortex and speech area. Results : Out of eight patients with parietal epilepsy, three had sensory aura, two had gustatory aura, and two had visual aura. Six of nine patients with occipital epilepsy had visual auras. All had complex partial seizures with lateralizing signs in 15 patients. Four had quadrantopsia. One had mild right hemiparesis. Abnormality in MRI was noticed in six out of eight parietal epilepsy and in eight out of nine occipital epilepsy. 3D-surface rendering of MRI visualized volumetric abnormality with geometric spatial relationships adjacent to the normal brain, in all of parietal and occipital epilepsy. Surface EEG recording was not reliable in localizing the epileptogenic zone in any patient. The subdural grid electrodes can be implanted on the core of the structural abnormality in 3D-reconstructed brain. Ictal onset zone was localized accurately by subdural grid EEGs in 16 patients. Motor cortex in nine and sensory speech area in two were identified by electrocortical stimulation. Histopathologic findings revealed cortical dysplasia in 10 patients ; tuberous sclerosis was combined in two, hamartoma and ganglioglioma in one each, and subpial gliosis in six. Eleven patients were seizure free at follow-up of 6 months to 37 months(mean 19.7 months) after surgery. Seizures recurred in two and were unchanged in one. Six produced transient sensory loss and one developed hemiparesis and tactile agnosia. One revealed transient apraxia. Two patients with preoperative quadrantopsia developed homonymous hemianopsia. Conclusion : This study suggests that surgical treatment was relevant in parietal and occipital epilepsies with good surgical outcome, without significant neurologic sequelae. Neuroimaging studies including conventional MRI, 3Dsurface rendering of MRI were necessary in identifying the epileptogenic zone. In particular, 3D-surface rendering of MRI was very helpful in presuming the epileptogenic zone in patients with unidentifiable lesion in the conventional MRI, in planning surgical approach to lesions, and also in making a decision of the extent of the epileptogenic zone in patients with identifiable lesion in conventional MRI. Invasive EEG recording with the subdural grid electrodes helped to confirm a core of the epileptogenic zone which was revealed in 3D-surface rendered brain.

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EXPERIMENTAL STUDY ON RELAPSE AFTER RAMAL LENGTHENING IN DIFFERENT SURGICAL METHODS - RADIOGRAPHIC EVALUATION (하악지 길이증가를 위한 수술방법들간의 회귀현상에 관한 실험적 연구)

  • Yi, Choong-Kook;Chang, Hyun-Ho;Park, Jung-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.636-643
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    • 2000
  • Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn't approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year. By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.

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Tooth Movement in Demineralized Area by Etchant in Rabbits

  • Choi, Bohm;Kim, Tae-Gun;Han, Seung-Hee;Park, Yoon-Hee;Lee, Won
    • Journal of Korean Dental Science
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    • v.5 no.1
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    • pp.37-44
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    • 2012
  • Purpose: Among the facilitation of tooth movement in adult orthodontic treatment methods, surgical approaches are gaining popularity but complications following mechanical bone reduction are a problem. In this study, tooth movement was observed after alveolar bone was chemically demineralized to verify whether tooth movement had been facilitated. Materials and Methods: Twelve rabbits were used. In the experimental group, the alveolar bone of the left first molar area was exposed and demineralized. Thirty seven percents phosphoric acid was applied for 5 minutes for demineralization. The opposite first molar area was used as control. Two teeth were pulled with 200 g force and 4 rabbits each were sacrificed at 3, 7, and 14 days after the force was applied. Histologic examination was done with hematoxylin and eosin and tartrate-resistant acid phosphatase staining. Result: The histologic examination results revealed more bone resorption in the demineralized area. As time passed, the number of osteoclasts increased in the compressed area. The amount of tooth movement was larger in the experimental group compared to the control group but the difference was not statistically significant. Conclusion: The demineralization with etchant resulted in limited bone resorption, more tooth movement and less damage of the cementum after applied orthodontic force.

Dual Preconditioning Effect of Dexamethasone and Epinephrine on TRAM flap Survival in Rats (덱사메타손과 에피네프린의 이중 전처치가 횡복직근피판 생존에 미치는 영향)

  • Kim, Jae Woo;Kim, Jun Hyuk;Ahn, Hyoung Sik;Shin, Ho Sung;Choi, Hwan Jun;Lee, Young Man
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.163-168
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    • 2007
  • Purpose: The flap delay is a widely used technique to increase the flap survival. Dexamethasone is a well-known drug to have a positive impact on the flap survival. The objective of this study is to investigate the dual synergic effect of epinephrine as a chemical delay agent plus dexamethasone on the TRAM flap survival in rat model. Methods: Forty Sparague-Dawley rats were divided into 4 groups evenly and a right inferior epigastic vessel pedicled TRAM flap, sized $5.0{\times}3.0cm$, was elevated on each upper abdomen. In the control group(N=10), 2 ml saline was injected on transverse abdominis muscle for a week before the flap elevation. In surgical delay group(N=10) all superior pedicles and left inferior pedicle were ligated a week before the flap elevation. In epinephrine group (N=10), 1 : 50000 epinephrine mixed saline was injected to transverse abdominis muscle every day for a week before flap elevation. In epinephrine plus dexamethasone group (N=10), the same procedure as that of epinephrine group was conducted for a week and 2.5 ml/kg dexamethasone was injected transverse abdominis muscle 2 hours before the flap elevation. On the seventh day after flap elevation, the survival area of flaps were measured and the vessel numbers in upper dermis of flap were counted through histologic slides. Results: The results were as follows: the mean percentage of the flap survival area of surgical delay group ($60.5{\pm}2.44%$), epinephrine group ($75{\pm}4.43%$), and epinephrine plus dexamethasone group ($87{\pm}1.94%$) were higher than that of the control group ($35{\pm}6.06%$) significantly(p<0.05). In case of the vessel number though histologic slides, epinephrine group ($79.3{\pm}5.57$) and epinephrine plus dexamethasone group ($96.3{\pm}14.05$) were higher than that of the control group ($44.8{\pm}8.82$) significantly(p<0.05), but the surgical delay group ($54{\pm}4.23$) showed no significant difference (p>0.05) compared to that of the control group. Conclusion: The results indicated that epinephrine plus dexamethasone injection before the flap elevation could be used to increase the TRAM flap survival area in rat model.

Pulmonary Hydatid Cyst - One Case Report - (폐포충낭종 수술치험 1예)

  • 권우석
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.918-923
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    • 1988
  • Hydatid disease still remains an important public health problem in many temperate and subtropical areas of the world. Hydatid disease is very rare in Korea. Recently, increase of abroad employment and tour into the endemic area brings into increase of the disease. We experienced a surgical case of unilocular hydatid cyst of lung in a 26 year old man. He had worked for a year[1986] in Libya. Hydatid cyst in left lower lobe was treated by lobectomy.

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