RESUMO
The dermoid cyst is the one of common space occupying orbital lesion. This lesion is regarded as a non-invasive tumor, but infrequently causes destruction of adjacent bony structure and displacement of adjacent tissue. We experienced a characteristic ovoid orbital dermoid cyst that occupied in the frontal sinus and causes displacement of the eyeball with well-defined lining. This 55-year-old male presented a mass in left orbit, which rapidly increased in size for past 12 months, and patient could not open left eyelid. We removed this tumor totally then reconstructed the orbital roof and frontal sinus with an iliac bone graft and polyethylene sheet(Medpor Newnan, USA). This patient was followed up for 12 months and patient obtained satisfactory result without any complication suck as recurrence or infection.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Cisto Dermoide , Pálpebras , Seio Frontal , Órbita , Polietileno , Recidiva , TransplantesRESUMO
PURPOSE: To report two cases of recurrent iris cyst, that were treated with argon laser photocoagulation and Nd: YAG laser cystotomy. METHODS: A 56 year-old woman with a history of cataract surgery and trabeculectomy in the right eye 15 months ago was presented with ocular irritation and decreased vision, and a 34 year-old man with a history of ocular trauma in the right eye 10 years ago was presented with photopsia and decreased vision. The recurrent secondary iris cyst was diagnosed in both patients. Argon laser photocoagulation and Nd: YAG laser cystotomy used to coagulate the cysts under the topical anesthesia. After 15 months, recurrent iris cyst developed at the same site of the second patient. The argon laser photocoagulation and Nd: YAG laser cystotomy were repeated. RESULTS: The treatment with argon laser photocoagulation and Nd: YAG laser was effective for the resolution of the recurrent secondary iris cysts.
Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Anestesia , Argônio , Catarata , Cistotomia , Iris , Lasers de Estado Sólido , Fotocoagulação , TrabeculectomiaRESUMO
In general, excision of a constriction ring is not difficult when performed several months after birth, but care should be taken to excise the scar tissue in newborns so as to avoid neurovascular damage. Although Hall et al. and Greene described successful one-stage operations in cases of forearm and leg constriction rings, a two staged Z-plasty around the circumference of the constriction is recommended in neonatal balloon. The authors in this article excised constriction ring through a single operation with Z-plasty, and restored digital contour. In order to preserve neurovascular structures, the authors employed loupe(x3.5) and prevented inadequate sensation and cold intolerance, which may occur after surgery. A one-stage release of congenital constriction ring was performed for 5 constriction rings in four extremities(one patient). No wound problems occurred, even when there had been marked congestion of the extremity distal to the constriction ring. The one-stage release facilitated postoperative care, and there was no need for additional anesthesia or for additional operations, which are necessary when this problem is treated with a release performed in two or three stages.
Assuntos
Humanos , Recém-Nascido , Anestesia , Cicatriz , Constrição , Estrogênios Conjugados (USP) , Extremidades , Antebraço , Perna (Membro) , Parto , Cuidados Pós-Operatórios , Sensação , Ferimentos e LesõesRESUMO
PURPOSE: The analgesic efficacy and side-effects of continuous intravenous infusion of Butorphanol for postoperative pain relief after evisceration were evaluated. METHODS: We evaluated the postoperative pain using Numerical Rating Scale in 19patients undergoing evisceration under general anesthesia. One group (group2, 9patients) received continuous intravenous injection of Butorphanol 14 mg mixed with 5% D/W 100ml using silicone balloon infuser for 2days. The other group (group1, 10patients) was not received it. RESULTS: The second group patients reported less pain compared to the first group patients in the first and second post operative day. The total NRS value of pain was 28.1+/-4.73 (group1) vs 11.22+/-0.99 (group2). CONCLUSIONS: For 48hr post operative pain relief in patients undergoing evisceration, the analgesic efficacy of the continuous intravenous injection of Butorphanol is useful.
Assuntos
Humanos , Anestesia Geral , Butorfanol , Infusões Intravenosas , Injeções Intravenosas , Dor Pós-Operatória , SiliconesRESUMO
During revascularization after ischemia, oxygen free radicals and cytotoxic enzymes are released and they have a role in pathogenesis of ischemia-reperfusion injury. Glucocorticoid decreases oxygen free radical formation by inhibition of arachidonic acid metabolism, and alpha-lipoic acid scavenges nitric oxide(NO) with inhibition of hydroxy radical formation. Author investigated the role of glucocorticoid and alpha-lipoic acid to decrease ischemia reperfusion injury in 24 anesthetized rats (normal saline-injected, n= 8; dexamethasone-injected, n=8; alpha-lipoic acid-injected, n= 8), subjecting a soleus muscle to 4 hours of tourniquet ischemia followed by 2 hours of reperfusion, and evaluated the concentration of NO, tissue edema, and neutrophil count of rat skeletal muscle as a indicator of tissue damage by ischemia- reperfusion injury. We obtained the results that glucocorticoid and alpha-lipoic acid treatment decreased the increase of NO concentration, tissue edema, and neutrophil count significantly. These results support that pretreatment with glucocorticoid or alpha-lipoic acid has a beneficial effect on the preventive management of ischemia-reperfusion injury.
Assuntos
Animais , Ratos , Ácido Araquidônico , Edema , Radicais Livres , Isquemia , Metabolismo , Músculo Esquelético , Neutrófilos , Oxigênio , Reperfusão , Traumatismo por Reperfusão , Ácido Tióctico , TorniquetesRESUMO
UUse of the gastrocnemius muscle flap has proven to be highly effective in reconstruction of knee and lower leg defect due to its easy procedure, anatomical consistency, and less donor site morbidity.The gastrocnemius muscle is anatomically spindle shape, the volume of the distal part of the muscle for coverage is actually quite small and also even smaller when disuse atrophy is accompanied due to trauma. Although the defect is inside flap's arc of rotation, it is out of gastrocnemius muscle flap's indication when the defect size is extensive, and even though the defect is small, it is also out of indication when the defect is a bit out of arc of rotation. There has been a lot of modification to increase the flap's arc of rotation or dimension. However, it is difficult to achieve satisfactory results due to limitation and expense in clinical application. Authors used, for soft tissue reconstruction on broader area, gastrocnemius musculo-adipofascial flap, rather than classical gastrocnemius muscle flap, based on the fascial plexus of gastrocnemius muscle. We obtained a good result in lower extremity reconstruction of 7 cases from March 1999 to July 2000 and report this result with several cases.