• Title/Summary/Keyword: 경구적 접근법

Search Result 7, Processing Time 0.023 seconds

The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
    • /
    • v.29 no.3
    • /
    • pp.379-388
    • /
    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

  • PDF

Microsurgical Anatomy in Transoral Odontoidectomy (경구강 치상돌기제거술의 수술해부학)

  • Park, Kwan;Lee, Sang Koo;Cho, Tae Goo;Nam, Do-Hyun;Lee, Jung-Il;Kim, Jong-Soo;Hong, Seung-Chyul;Shin, Hyung-Jin;Eoh, Whan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
    • /
    • v.29 no.3
    • /
    • pp.309-316
    • /
    • 2000
  • Objective :The transoral approach allows direct view of the ventral craniovertebral junction and provides useful management of the various lesions of this area. We present a step by step guide to the performance of the transoral excision of the odontoid process in the cadaveric model. Methods : Ten cadaver heads were used in fixed or unfixed state. We describe the relevant surgical anatomy in the cadaveric dissection and surgical technique of transoral transpharyngeal odontoidectomy. Results : The surgical procedure of transoral odontoidectomy was categorized by six steps;soft palate, posterior pharyngeal wall, muscular structures, osseous structures, odontoid process and ligaments, cruciate ligament and dura. Conclusion : With anatomical knowledge of these regions neurosurgeons can deal with wide variety of lesions in the ventral craniovertebral junction.

  • PDF

선천성 후두열

  • 백정환;권중근;손영익;추광철
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1996.04a
    • /
    • pp.81-81
    • /
    • 1996
  • 선천성 후두열은 매우 드문 선천성 기형으로 신생아에게 심각한 호흡곤란 및 수유장애를 초래할 수 있다. 해부학적 결손정도와 관련된 기형에 따라 다양한 증상이 나타난다. 가장 흔한 특징적 증상으로는 흡기시 천명, 간헐적으로 나타나는 수유시 호홉곤란을 들 수 있다. 이 증상들은 후두연화증, 성대마비, 후비공폐색 둥과 같은 다른 선천성 기형에서도 나타나기 때문에 미리 의심하지 못하면 진단이 어렵다. 따라서 진단을 위해서는 세심한 주의와 정확한 내시경 검사가 필요하다. 저자들은 선천성 후두열 2례를 경험하였다. 첫 증례는 제 II형이었고 두번째는 III형이었으며, 두 증례 모두 전방 후두열 접근법으로 치료하였다. 제 III형 환아는 술전 흡기시 천명을 동반한 호흡곤란과 여러번의 흡인성 폐렴을 겪었으며 술후 캐놀라발거는 가능하였으나 경구를 통한 수유시 흡인을 동반하여 현재까지 위루술을 통해 음식을 섭취하고 있는 상태이다. 저자들은 최근 경험한 선천성 후두열 2례를 video presentation과 함께 보고하는 바이다.

  • PDF

SURGICAL REPAIR OF COMPLETE BONY BILATERAL CHOANAL ATRESIA VIA TRANSPALATAL APPROACH (완전 골성 양측성 후비공 폐쇄 환자의 구개부를 통한 외과적 치험례)

  • Kim, Kyoung-Won;Cho, Yong-Seok;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.20 no.2
    • /
    • pp.133-138
    • /
    • 1998
  • Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

  • PDF

Data Flow Analysis of Secure Information-Flow in Core Imperative Programs (명령형 프로그램의 핵심부분에 대한 정보흐름 보안성의 데이타 흐름 분석)

  • 신승철;변석우;정주희;도경구
    • Journal of KIISE:Software and Applications
    • /
    • v.31 no.5
    • /
    • pp.667-676
    • /
    • 2004
  • This paper uses the standard technique of data flow analysis to solve the problem of secure information-flow in core imperative programs. The existing methods tend to be overly conservative, giving “insecure” answers to many “secure” programs. The method described in this paper is designed to be more precise than previous syntactic approaches. The soundness of the analysis is proved.

Diagnostic Performance of Routine Objective Tests and Cost-Effective Approach for Chronic Cough (만성 기침의 진단 성적과 경제적 접근 모델)

  • Jeon, Gang;Jang, Seung Hun;Song, Hae Geun;Ha, Jun-Wook;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Park, Yong Bum;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
    • /
    • v.57 no.6
    • /
    • pp.535-542
    • /
    • 2004
  • Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.

Inhibitory Effect of Rhus Verniciflua Extract on Lipid Peroxidation and Inflammatory Cytokines during Endurance Exercise Training (지구성 운동시 옻나무 추출액의 지질과산화 및 염증성사이토카인 억제효과)

  • Lee, Youn-Kyung;Kwon, Oh-Seon;Song, Young-Ju;Kim, Sea-Hyun;Kim, Pan-Gi;Ryu, Sung-Pil
    • Journal of Korean Society of Forest Science
    • /
    • v.99 no.1
    • /
    • pp.102-110
    • /
    • 2010
  • This study was performed to find out the inhibitory effect of Rhus Verniciflua extract on lipid peroxidation and inflammatory cytokines during endurance exercise training for 8 weeks in rats. For this study, Sprague-Dawley rats were divided into 4 groups; sedentary (SED), exercise training (TRA), RVS extract ingestion (RVE), and RVS extract ingestion and exercise training (RVE-TRA). TRA and RVE-TRA were trained on treadmill with increasing speed gradually and administered 10 mL/kg/d of Rhus Verniciflua extract orally to RVE and RVE-TRA. In order to analyze antioxidant function, blood SOD (superoxide dismutase), GSH-Px (glutathione peroxidase), and MDA (malondialdehyde) were examined. And, analysis of inflammatory cytokines were examined using IL-6 (interleukin-6), TNF-${\alpha}$ (tumor necrosis factor-alpha), CRP (C-reactive protein), and NO (nitric oxide). SOD in TRA was significantly higher than SED and RVE (p<0.05), and RVE-TRA was highest among the groups (p<0.05). The MDA content of TRA, RVE and RVE-TRA were significantly lower than SED. GSH-Px activity of SED was significantly lower than other groups (p<0.05). IL-6 and TNF-${\alpha}$ content of RVE and RVE-TRA were significantly lower than SED and TRA (p<0.05). CRP concentration of SED was the lowest among groups (p<0.05). Finally, NO concentration of SED and TRA were higher than RVE and RVE-TRA (p<0.05). These results suggested that it is efficient for rats to reduce lipid peroxidation and induce anti-inflammatory by taking RVS extract during exercise training. Afterwards, if studies on the properties of RVS extract can be made with various ways, use of Rhus Verniciflua trees might be made widely which are growing naturally in mountains in Korea.