Postoperative respiratory difficulty due to asymptomatic anterior cervical osteophyte after brain tumor surgery: a case report / 대한마취과학회지

Anterior cervical osteophytes are commonly found in elderly patients, but rarely produce symptoms. When symptoms occur, they can range from mild symptoms of dysphagia, dysphonia, and foreign body sensation to severe symptoms of airway obstruction due to compression of the pharynx or larynx. We report the case of a 59-year-old man who underwent brain tumor surgery, and developed post-operative respiratory difficulty due to progressive pharyngo-laryngeal edema, requiring urgent endotracheal intubation, secondary to the presence of a previously asymptomatic anterior cervical osteophyte. It is paramount to recognize that asymptomatic anterior cervical osteophytes are a potential cause of life-threatening post-operative respiratory complications that can rapidly progress to life-threatening airway obstruction after surgeries in the prone position, especially in elderly patients.

True Aneurysm of the Common Digital Artery: Case Report

PURPOSE: An aneurysm is defined as a permanent, localized dilation of an artery with a 50% increase in diameter over its expected normal diameter. Aneurysms can be classified by cause as traumatic and nontraumatic. Traumatic aneurysms can be divided into true and false aneurysms. Nontraumatic causes of peripheral artery aneurysms include mycotic, atherosclerotic, inflammatory, and idiopathic. In the hand, true aneurysms occurring at the common digital artery have been rarely reported. We present a rare case of a true aneurysm of the common digital artery that was resected and reconstructed using a reversed vein graft. METHODS: A 49-year-old male patient was refered to our institution with a 0.73x0.44x1.37cm sized pulsating mass between 2nd and 3rd flexor digitorum tendons on Lt. palm area. The mass had been present for 5 years and had increased in size over the previous year. No history of trauma was reported. After a physical examination and ultrasound sonography review, a diagnosis of aneurismal dilatation of common digital artery was made. Surgical treatment by excision of the aneurysm, and a reversed vein graft was performed. RESULTS: Histologic examination of the specimen(3.4x0.7cm) showed aneurismal dilatation, with elastin fibers present in the arterial wall. The lesions were healed without any complications and there were no evidence of recurrence. Doppler examination of the reconstruction showed good perfusion. CONCLUSION: Early excision is recommended to relieve symptoms and avoid neurologic damage. Also, artery reconstruction can be performed by primary end-to-end anastomosis or the placement of a reversed interposition vein graft. Micro surgical repair was the only possible treatment in this case. The authors believe that the vascular anatomy should always be restored as natural as possible.

The Efficacy of New Hyaluronic Acid Filler (HyaFilia)

PURPOSE: Currently, soft tissue filler products based on hyaluronic acid are widely used. They are safe, effective, and convenient to use compared with bovine collagens. However, all commercially available hyaluronic acid based fillers in Korea are imported ones. The purpose of this study is to evaluate efficacy of a new hyaluronic acid filler (HyaFilia; CHA bio&Diostech Co., Seoul), which has been recently developed in Korea. METHODS: Three kinds of soft tissue fillers, including Restylane(Q-Med, Uppsala, Sweden), HyaFilia(CHA bio & Diostech Co., Seoul), Juvederm(Allergan, CA, USA), were injected subdermally into the back of hairless mice at six sites. The 2 cephalic sites composed Restylane groups, the 2 middle sites HyaFilia groups, and the 2 caudal sites Juvederm groups. Six hairless mice were included in the study, therefore, a total of 12 injections per group were performed. After 16 weeks after injection, the nodular swellings that resulted from the injections were excised wide enough to include skin beyond the swelling points down to the panniculus carnosus layer using 8mm punches. Volumes and weights were measured using a stereoimage optical topometer system and a weighting machine. Histologic comparisons were also carried out. RESULTS: The mean volumes of the Restylane, HyaFilia and Juvederm groups were 3698 x 103, 4820 x 103, and 1435 x 103 PI, respectively. The mean weights of the Restylane, HyaFilia and Juvederm groups were 36.08, 37.83, and 24.66mg, respectively. Histologic examination between the 3 groups showed no significant difference in tissue compositions and inflammatory reactions. CONCLUSION: The results of this study shows that HyaFilia is superior to Restylane and Juvederm in longavity of filling effect. Therefore, HyaFilia may be an effective replacement for the imported materials including Restylane and Juvederm.