Three-dimensional solid model has not been widely used in surgical prediction of orthognathic surgery because freque from occlusal restorations or prosthesis limited the usefulness of simulated surgery involving occlusion. We prepared three-dimensional(3D) solid model from CT data and integrated the 3D solid model with dental cast using a face-bow transfer technique combined with skeletal reference measurement and confirmation with cephalometric radiographs. With this simple and easy method, it was possible to predict bony interference between the proximal and distal segment of the mandible so that we can prevent condylar displacement after sagittal split ramus osteotomy of the mandible with prominent asymmetry. The method error was within 2mm and it seemed to be useful in preoperative planning for maxillofacial surgery with maxillo-mandibular occlusal change
Mandible* ; Orthognathic Surgery* ; Osteotomy, Sagittal Split Ramus ; Prostheses and Implants ; Surgery, Oral

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

BACKGROUND AND OBJECTIVES: In acute myocardial ischemia, the conduction velocity of action potential is decreased by several electrophysiological and physical factors. The ventricular activation time(VAT) is a time duration of electrical impulse propagating from endocardium to epicardium. The goal of this study is to determine whether the reduction in conduction velocity in acute myocardial ischemia can lead a change in VAT. MATERIALS AND METHOD: Thirty patient, 18 males and 12 females, who had received percutaneous balloon coronary angioplasty(PTCA) were enrolled. The mean age was 59 years old. A twelve lead surface electrocardiogram(ECG) were obtained before, during, 1 minute, 5 minutes, and 10 minutes after the PTCA as digitized data by using Cardiolab EP 4.1 program. The magnitude of the QRS wave was amplified 3 to 4 folds and the speed was increased to 200mm/sec in order to get the VAT easily and accurately. The data was the mean of three consecutive VATs. The number of vessel treated with PTCA included left anterior descending artery(12), left circumflex artery(9), and right coronary artery(9). Among twelve chronic stable angina, sixteen unstable angina, and two acute myocardial infarction patients, twenty six had single and four had two vessel diseases. RESULTS: The significant increase in VAT during PTCA compared to that before PTCA was observed in eight of 12 leads. In addition, the significant decrease in VAT of 1, 5, and 10 minutes after PTCA compared to that during PTCA were noted. Furthermore, 10 minutes after PTCA, VAT decreased significantly compared to that before PTCA. The leads did not show a significant change of VAT depending on target vessels. The ECG of 16 patients showed changes of the ST segment during PTCA. The changes of VAT were not related to the ST segment change. CONCLUSION: The conduction delay from endocardium to epicardium in acute myocardial ischemia was presented as a prolongation of VAT in surface ECG. In addition, the conduction delay was recovered within 5 minutes after relief of ischemia. Therefore, the changes of VAT can possibly be used as one of the noninvasive parameters of myocardial ischemia.
Action Potentials ; Angina, Stable ; Angina, Unstable ; Electrocardiography ; Endocardium ; Female ; Humans ; Ischemia ; Male ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia* ; Pericardium ; Thoracic Surgery, Video-Assisted

Central retinal artery occlusion occurs rarely as a complication of spine surgery under general anesthesia in prone position, but is quite tragic. The suggested causes are hypotension during anesthesia and increased external ocular pressure by headrest, sand bag or others. We experienced a case of left central retinal artery occlusion following cervical spine surgery under general anesthesia using a horseshoe headrest. The patient was 53 years old male whose medical history was non remarkable except dislocation of cervical spine. He was positioned prone after induction. The vital signs were stable during opreration. At the recovery room, he presented left visual field disturbance and investigations revealed that left central retinal artery occlusion occured. This case demonstrates that proper positioning of the head on an adequate head rest and contineous cautious inspection during surgical procedure are important to prevent retinal damage.
Anesthesia ; Anesthesia, General* ; Dislocations ; Head ; Humans ; Hypotension ; Male ; Middle Aged ; Prone Position* ; Recovery Room ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde ; Silicon Dioxide ; Spine* ; Visual Fields ; Vital Signs

This is to report the technique of reversed iliac leg stent-graft in endovascular treatment for isolated internal iliac artery (IIA) aneurysm, which had significant size discrepancy between the common iliac artery (CIA) and external iliac artery (EIA) in 3 patients from different hospitals. Three patients were a 85- and two 82-year-old men. Treated were right IIA aneurysms, sized 6.5x6.2 cm, 5.0x4.0 cm, and 4.1 cm in longest diameter, respectively. The diameters of the right CIA and right EIA measured 21 mm/11 mm, 15 mm/11 mm, and 20 mm/10 mm, respectively. In all cases, reversed iliac leg stent-grafts were prepared on-site; unsheathed and mounted upside-down manually, and deployed in each right CIA. Post-stent-graft angiograms showed complete exclusion of the aneurysms, except for minimal type 1 endoleak in one case. This technique is a useful treatment option in patients with isolated IIA aneurysm.
Aged, 80 and over ; Aneurysm* ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Aneurysm ; Iliac Artery* ; Leg* ; Male

PURPOSE: To report one case of pleomorphic adenoma of the lacrimal gland in a child. CASE SUMMARY: A 7-year-old boy presented with a 2-month history of an exophthalmos and mild ptosis of the left eye; there were no other ophthalmologic problems. Orbit MRI revealed a well-defined mass in the left lacrimal gland and a defect in the orbital roof due to pressure erosion. Tumor resection was performed via a lateral orbitotomy and a biopsy was requested. The biopsy revealed tumor tissue that was composed of epithelial elements with variably sized duct formation. Focal squamous metaplasia and keratin production was also observed. CONCLUSIONS: Pleomorphic adenoma of the lacrimal gland should be considered as a differential diagnosis of a lacrimal gland mass in a child.
Adenoma, Pleomorphic* ; Biopsy ; Child* ; Diagnosis, Differential ; Exophthalmos ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Male ; Metaplasia ; Orbit

PURPOSE: Recently, in an experiment using animals, radiation therapy using a laser or Tending Diancibo Pu (TDP) has been shown to be effective in treating scars on the skin by increasing the production of fibroblast cell and collagen and by accelerating the process of epithelization. The purpose of this study is to examine the effectiveness of TDP radiation therapy in treating human burn injuries in terms of the frequency of treatment, the timing of eschar separation, and the duration of treatment. METHODS: In the treatment group, the burn area of the patients was first sterilized with saline solution and potadin solution and covered with one vaseline gauze. Then, the burn area was radiated every other day by using TDP for 20 minutes at distance of 20-25 cm, at radiant plate temperature of 250-280oC. In the cases of control group, the burn area of the patients was first sterilized with saline solution and potadin solution and covered with one vaseline gauze. Then, the area was covered with one burn gauze and bandaged. The treatment was conducted every other day. RESULTS: In cases of superficial second degree burn injuries, the difference between the treatment and the control groups was 1.34 in terms of the frequency of treatment. In the cases of both superficial and deep second degree burns, the differences between the treatment and the control groups were 3.47 in terms of the frequency of treatment, 0.63 weeks in terms of the timing of eschar separation, and 6.03 days in terms of the duration of treatment. All these differences were statistically significant. CONCLUSION: From the experiment, it can be concluded that TDP radiation therapy is more effective in treating human burn injuries than conventional treatment in terms of the of the frequency of treatment, the timing of eschar separation, and the duration of treatment.
Animals ; Burns* ; Cicatrix ; Collagen ; Fibroblasts ; Humans ; Petrolatum ; Skin ; Sodium Chloride

Heorrhage and infarct-like necrosis of anterior lobe of the pituitary gland is one of the characteristic pathologic findings of the autopsied cases of Korean Hemorrhagic Fever (KHF) patients, but there has been rare reports of hypopituitarism in patients with KHF. Recently we have experienced a patient with hyponatremia who had recovered from KHF. He was admitted to our hospital due to nausea, vomiting, and epigastric discornfort. To determine the function of the anterior pituitary gland, hormonal levels of target galnds and pituitary gland were measured, and combined pituitary stimulation test was performed. ACTH, GH, and prolactin deficiency were confirmed by combined pituitary stimulation test in this patient. There was no evidence of hypothalamic or other pituitary diseases by brain MRI. Our experience shows that KHF can be a cause of hypopituitarism and these findings should alert physicians the possibility of hypopituitarisrn in patients who had recovered from KHF.
Adrenocorticotropic Hormone ; Brain ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hyponatremia ; Hypopituitarism* ; Magnetic Resonance Imaging ; Nausea ; Necrosis ; Pituitary Diseases ; Pituitary Gland ; Pituitary Gland, Anterior ; Prolactin ; Vomiting

Anesthesia, Local ; Cautery ; Epistaxis ; Hemorrhage ; Hemostasis ; Humans ; Ligation

Amnesia, Anterograde ; Anxiety ; Conscious Sedation ; Consciousness Disorders ; Dizziness ; Headache ; Humans ; Nausea ; Physical Stimulation ; Surgery, Oral ; Vomiting