• Title/Summary/Keyword: 결절절제수술

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Spinal Ganglion Cyst of Lumbar Posterior Longitudinal Ligament (요추부 후종인대에서 발생한 결절종)

  • Roh, Sung Woo;Rhim, Seung Chul;Lee, Ho Kyu;Kang, Sin Kwang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.543-549
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    • 2000
  • Objective : In contrary to ganglion cyst that commonly develops in connective tissue of peripheral joint or tendon, spinal ganglion cysts have been rarely reported. The authors report five cases of spinal ganglion cysts which originated from posterior longitudinal ligament of the lumbar spine. Methods : The authors retrospectively analyzed clinical, radiological, and surgical findings of five cases of spinal ganglion cysts and speculated the pathogenesis of spinal ganglion cyst. Result : Cysts were excised totally and symptoms improved without complications in all cases. Intraoperative findings revealed cysts that were tightly adherent to posterior longitudinal ligament. Conclusion : Five cases of ganglion cyst which caused similar symptoms and signs those of lumbar disc herniations were excised successfully. MRI and operative findings suggested spinal ganglion cyst of posterior longitudinal ligament were closely associated with disc degeneration which imply disc degeneration or herniation may play an important role in the pathogenesis of ganglion cyst.

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Combined Arthroscopic Gross Total Synovectomy and Radiotherapy for Diffuse Pigmented Villonodular Synovitis of the Knee: A Report of 2 Cases (무릎관절의 미만형 색소 융모 결절성 활액막염에서 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료: 증례보고)

  • Chang, Sei-Kyung;Kim, Jae-Hwa;Ha, Doo-Hoe;Kang, Hae-Youn;Chong, So-Young;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.201-206
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    • 2006
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

Giant Tophi Involving Both Suprapatellar Pouches and Upper Poles of the Patellae: Treatment with Febuxostat and the 6 Years Follow-Up (슬개골낭과 상부 슬개골을 침범한 무증상성 거대 통풍 결절: 약물 치료 후 경과관찰 6년 추시)

  • Kim, Sung Tae;Lee, Sang Yup;Kim, Sang Jae;Kim, Bum Soo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.78-83
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    • 2019
  • Tophi is one of the clinical manifestations of gout. On the other hand, it does not draw the patient's attention when it is asymptomatic, which leads to delayed management. The current case is a typical example of delayed diagnosis and management. The authors' preferred management of tophi was medical not surgical, even though the hitherto therapeutic issue has been conservative versus surgical. The authors chose conservative treatment in the osteolytic lesion resulting from huge tophi in the patella, and the report the results of 6 years follow-up.

Effective and Safe Application of Radiofrequency Ablation for Benign Thyroid Nodules (양성갑상선결절에 대한 효과적이고 안전한 고주파절제의 적용)

  • Jin Yong Sung
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.985-998
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    • 2023
  • Radiofrequency ablation (RFA) has been a representative, non-surgical treatment for benign thyroid nodules that cause cosmetic problems or compression symptoms. The procedure of RFA should be performed effectively and safely. This review discusses the patient selection, pre-procedure evaluation and planning, principles, devices, techniques, and complications with reference to the guidelines and research on thyroid RFA. In particular, this review will devote to introduce RFA techniques and to provide practical help in the implementation of this procedure.

Diffuse Pigmented Villonodular Synovitis of the Knee: Case Report (무릎 관절의 미만형 색소 융모 활액막염: 증례 보고)

  • Choi, Sang-Gyu
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.278-282
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    • 2007
  • Purpose: Diffuse pigmented villonodular synovitis (PVNS) is an uncommon aggressive synovial proliferative disorder of unknown etiology affecting the joint linings. Though a histologically benign inflammatory process, because of its aggressive growth with bone destruction or recurrence, it is frequently suggested to occur as a low malignant neoplasm. Optimal treatment is surgery, but the local recurrence rate after radical synovectomy for diffuse PVNS is relatively high due to the infiltrative growth pattern. External beam radiotherapy with moderate doses or intra-articular instillation of radioactive isotopes may improve the likelihood of local control and long-term function in patients with incompletely resected or recurrent diffuse PVNS. I report one case of diffuse PVNS of the right knee joint treated with arthroscopic synovectomy and external beam radiotherapy is presented.

Surgical Treatment of Arrhythmias Associated with Congenital Heart Disease (선천성 심장 기형에 동반된 부정맥에 대한 수술적 치료)

  • Hwang, Ui-Dong;Im, Yu-Mi;Park, Jeong-Jin;Seo, Dong-Man;Lee, Jae-Won;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.811-816
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    • 2007
  • Background: We analyzed our experience of arrhythmia surgery in patients with congenital heart disease. Material and Method: A retrospective review was performed on 43 consecutive patients with congenital heart disease, who underwent arrhythmia surgery between June 1998 and June 2006. Result: The median age at surgery was 52 years ($4{\sim}75$ years). The most frequent cardiac anomaly was an atrial septal defect (23/43, 53.5%). The types of arrhythmias were atrial flutter-fibrillation, intermittent non-sustainable ventricular tachycardia and others in 37, 2 and 4, respectively. Arrhythmia surgery consisted of a bi-atrial maze operation in 18 patients (modified cox maze III procedure in 5 patients, and a right side maze plus pulmonary vein cryo-isolation in 13), right side maze operation in 18 patients, cavo-tricuspid isthmus cryoablation for benign atrial flutter in 4 patients, right ventricular endocardial cryoablation in 2 patients and extranodal cryoablation for atrioventricular node re-entry tachycardia in 1 patient. The median follow-up was 23.8 months ($1{\sim}95.2$ months). There was no early mortality, and one late non-cardiac related death. The overall rates of restored sinus rhythm before discharge and $3{\sim}6$ months after surgery were 79% and 81%, respectively (bi-atrial maze group: 72% and 83%, right-side maze group: 77%, 77%). Conclusion: Arrhythmias associated with congenital heart disease can be safely treated surgically with an excellent intermediate-term outcome.

Trachea Necrosis after Thyroidectomy ; Case Report and Review (갑상선절제술 후 발생한 기도 괴사 ; 증례보고)

  • Choi, Ji Woo;Lee, Jeonghun;Song, Youngpeck;Kim, Chul-Ho;Soh, Euy Young
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.109-114
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    • 2014
  • 갑상선절제술은 내분비 외과의사가 하는 수술 중 가장 안전한 수술이지만 수술 중 기도나 식도가 손상 받을 수 있으므로 각별한 주의를 기울여야 한다. 특히 기도 괴사와 같이 생명에 위협을 주는 합병증이 있음을 유념해야 한다. 본 논문은 갑상선 전 절제술과 승모판 치환술을 함께 받은 72세 여성환자가 수술 후 3일만에 기도 괴사가 발생한 케이스이다. 3개의 기관륜에 걸쳐 괴사가 발생되어 있었다. 괴사된 조직을 제거하고, 이후 지속적인 괴사조직에 대한 제거와 치료와 적으로 기관개창술을 시행하고, 자연폐쇄를 유도하여 성공적으로 치료되었다. 비슷한 여러 논문들을 살펴본 결과 기도 괴사를 유발하는 요인으로는 조절되지 않는 기침, 여성, 갑상샘중독 결절, 기도 삽관 시 발생되는 손상, 삽관튜브 커프의 과팽창으로 기도가 장시간 높은 압력으로 압박되었을 때, 적절하기 않은 커프 크기, 삽관튜브 커프의 공기를 빼지 않고 무리하게 움직였을 때, 출혈이 많을 때, 과도한 전기소작으로 인한 손상, 기도로 가는 혈관손상으로 인한 혈액공급의 차단, 감염 등으로 보고 있다. 치료는 기도의 괴사와 감염의 정도에 따라 달라질 수 있다. 일차 봉합술, 일시적 스토마 형성, 일시적 기관조루술, 단단연결술, 기도 스텐트 설치술, 근육피판 재건술, 보존적 치료 등을 시행할 수 있다. 기도 괴사에 대한 위험인자와 치료에 대해서는 아직 확실히 적립되지 않은 상태이다. 드문 합병증이지만 생명을 위협할 수 있는 이러한 합병증에 대해 항상 염두 해 두고 수술 시 신중을 기하고 문제 발생시 신속한 대응을 해야겠다.

Clinical Outcomes of the Surgical Excision of the Ganglion Cyst Causing Compressive Neuropathy - A Review of Twelve Collected Cases - (압박 신경병증을 일으킨 결절종의 수술적 절제의 임상적 결과)

  • Jung, Sung-Taek;Cho, Seong-Beom;Moon, Eun-Sun;Lee, Jae-Joon;Kim, Ki-Hyeoung;Yang, Hyun-Kee
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.63-70
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    • 2006
  • Purpose: The purpose of current study was to review the surgical treatment results in patients with a ganglion cyst involving peripheral nerves and to suggest the poor prognostic factor. Materials and Methods: Twelve patients having neurologic symptoms caused by ganglion cyst were treated operatively between 1995 and 2000. The peripheral nerves involved were the tibial nerve in three patients, suprascapular nerve, common peroneal nerve, radial nerve, and ulnar nerve in two patients each, and median nerve in one patient. Pain was present in six patients, sensory disturbance or motor weakness was seen in seven patients each; and sensory disturbance and motor weakness were concurrently present in four patients. Results: In all six patients who complained of preoperative pain, the pain was resolved after surgery. Improvements were seen in five of seven patients who had preoperative sensory disturbance and in all patients who had preoperative motor weakness. Complete sensory recovery was obtained in only two of four patients with preoperative sensory disturbance and motor weakness, indicating a poor prognosis factor. Conclusion: Early accurate diagnosis and early excision of these ganglion cysts causing compression neuropathy could produce excellent clinical results.

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Clinical Study of Bronchioloalveolar Cell Carcinoma (기관지 폐포암의 임상적 특성)

  • Choi, Jin-Won;Park, Ik-Soo;Kim, Jin-Ho;Yoon, Ho-Joo;Shin, Dong-Ho;Kim, Tae-Wha;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.1
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    • pp.26-35
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    • 1994
  • Background: Bronchioloalveolar cell carcinoma today needs further studies as an early diagnosis will drastically improve the chances of cure. Methods: Twenty-four cases of bronchioloalveolar cell carcinoma for the period of 5 years were studied in terms of incidence, age, sex, underlying diseases, symptoms, radiographic findings, methods of diagnosis, clinical and pathologic staging, methods of treatment, and survival retrospectively. Results: No correlation was found between patients' age, sex and underlying diseases. Most common symptoms were cough(62.5%), chest pain(29.2%), and sputum(29.2%). Of the 24 cases, 13 patients(54.2%) had solitary nodule, 6 patients(25%) had multiple nodules. At the time of diagnosis, 3 patients(12.5%) had the stage I diseases, 3 patients(12.5%) had the stage II diseases, 4 patients(16.7%) had the stage IIIa diseases, 3 patients(12.5%) had the stage IIIb diseases, and 11 patients(45.8%) had the stage IV diseases. 14 cases(58.3%) were found inoperable at the time of admission; they all died within 17 months. In 7 cases with stage I, II, IIIa diseases curative resection were attempted, in 1 case with stage IV disease wedge resection for palliative management was performed, and in 4 cases patients were still alive at the time of conclusion of this study. Conclusion: We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.

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Pigmented Villonodular Synovitis of the Shoulder Associated with Rotator Cuff Tear - A Case Report - (회개근 개 파열과 동반된 색소 융모 결절성 활액막염 - 증례 보고 -)

  • Ha, Sung-Sik;Hong, Ki-Do;Sim, Jae-Chun;Kim, Tae-Ho;Cho, Hye-Jae;Kim, Jong-Hyun
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.275-279
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    • 2010
  • Purpose: Here we report a case of pigmented villonodular synovitis of the shoulder associated with a rotator cuff tear. Materials and Methods: A 52 year-old female who had suffered from pigmented villonodular synovitis of the shoulder associated with a rotator cuff tear was treated with arthroscopic synovectomy and subacromial decompression. Results: Pain was reduced and the patient achieved a good functional outcome after surgery. Conclusion: The current authors report a case of pigmented villonodular synovitis of the shoulder associated with rotator cuff tear and a review of literature.