• Title/Summary/Keyword: 보존적수술

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Treatment of Shepherd's Crook Deformity with Huckstep's nail in Fibrous Dysplasia - A Case Report - (섬유성 골이형성증에서 Huckstep 정을 이용한 Shepherd's Crook 변형의 치료 - 증례 보고 -)

  • Whang, Kuhn-Sung;Kim, Tae-Seung;Kim, Byoung-Hoon;Lee, Jong-Min
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.27-31
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    • 2002
  • Clinical symptoms of fibrous dysplasia in proximal femur include pain, limping, and leglength discrepancy. Occasionally varus deformity, which may range from mild coxa vara to a marked shepherd's crook deformity was developed. Surgical intervention generally is considered advisable in the presence of persistent pain unresponsive to conservative treatment or significant or progressive deformity. Depending on the lesion size, lesion site, and deformity, several treatment methods have been used. This is a report on one case of bilateral shepherd's crook deformity in fibrous dysplasia, which was treated with corrective osteotomy by Huckstep nail.

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Radiographic Changes of Bilateral Partial Avulsion Fracture of Tibial Tuberosity in a Dog (개에서 발생한 양측성 경골조면 부분 견열골절의 방사선학적 변화)

  • Keh, Seo-Yeon;Choi, Mi-Hyun;Lee, Nam-Soon;Jang, Jae-Young;Lee, Hae-Keong;Kim, Hyun-Wook;Yoon, Junghee
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.134-137
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    • 2013
  • A 4-month-old intact male Jindo dog was presented for left hindlimb lameness. On radiographs, a small mineralized piece was identified beneath the apophysis of tibia with no or minimal displacement of apophysis bilaterally. Subsequently, the cranioproximal bony aspect of the tibia changed radiolucent to radiopaque. The left side recovered after surgical management, but the right side was self-limited with conservative management. The diagnosis was partial avulsion fracture of the tibial tuberosity which has been called 'Osgood-Schlatter disease' in dogs.

Transvaginal Direct Puncture and Ethanol Sclerotherapy for Cervicovaginal Venous Malformations: A Case Report and Literature Review (자궁경부 및 질에 발생한 정맥기형에 대한 질 경유 직접 천자 및 에탄올 경화요법: 증례 보고 및 문헌 고찰)

  • Gu Seong Jeong;Suk Hyun Bae;Young Soo Do;Hyoung Nam Lee;Sang Joon Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.688-692
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    • 2021
  • Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of female. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.

Clinical Results after Repair of Rotator Cuff Tear in Patients with Accompanying AC Joint Pathology: Clinical Comparison of Non-operative Treatment (회전근개 파열과 동반된 견봉 쇄골 관절 병변이 회전근개 봉합술 후 결과에 미치는 영향: 비수술적 치료를 통한 임상적 비교)

  • Yoo, Moon-Jib;Seo, Joong-Bae;Lee, Dae-Hee;Kim, Sung-Jin
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.86-90
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    • 2012
  • Purpose: We studied the need for distal clavicle resection by comparing rotator cuff tear patients who underwent non-surgical treatment with and without acromioclavicular joint pathology. Materials and Methods: 45 cases that had been under follow up care for at least 9 months after receiving rotator cuff repair in our hospital between Jan. 2005 and Jun. 2011 had been studied. Acromioclavicular joint pathology group and control group were classified by physical examination and MRI findings. The temporal changes in shoulder joint abduction, internal and external rotation strength, ASES and KSS score of the two groups were measured and analyzed. Results: The acromioclavicular joint pathology complicated rotator cuff injury group's strength measurements for abduction, internal rotation, external rotation were each 8.05 (${\pm}4.54$), 11.33 (${\pm}6.05$), 10.24 (${\pm}5.27$) preoperatively and improved to 13.26 (${\pm}5.50$), 17.51 (${\pm}6.80$), 15.60 (${\pm}5.37$) post operatively while the KSS score and ASES score were each 49.07 (${\pm}15.28$) and 48.65 (${\pm}13.27$) preoperatively, improving to 84.48 (${\pm}10.96$) and 84.65. (${\pm}9.86$). The measurements for the group without complicating acromioclavicular pathology are as follows. The strength for abduction, internal rotation, external rotation was each 6.42 (${\pm}3.11$), 7.59 (${\pm}4.81$) and 7.93 (${\pm}4.49$) preoperatively, improving to 15.85 (${\pm}7.35$), 19.18 (${\pm}9.14$), 16.95 (${\pm}5.70$) post operatively, while the KSS score and ASES score each went from 42.12 (${\pm}6.43$) and 41.37 (${\pm}7.42$) to 83.44 (${\pm}6.30$) and 83.17 (${\pm}7.01$) respectively. The measurements for the two groups, however, did not show a statistically significant difference (p>0.05). Conclusion: Analysis of the rotator cuff injury groups with and without AC joint pathology showed that both groups had improved strength, ASES and KSS scores with no statistical difference difference among the groups. As such, it thought that conservative treatment is an acceptable alternative to distal clavicle resection.

Radiation Therapy for T2N0 Glottic Cancer (T2N0 병기 성문암의 방사선치료)

  • Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.217-222
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    • 2006
  • $\underline{Purpose}$: This study evaluated the results of definitive radiation therapy and the prognostic factors that affect survival rates for T2N0 glottic cancer patients. $\underline{Materials\;and\;Methods}$: Thirty patients with T2N0 glottic cancer who were treated with definitive radiation therapy at our institution between September 1986 and June 2004 were retrospectively reviewed. All patients were pathologically confirmed as having squamous cell carcinoma and were staged as AJCC T2N0. The age of the patients ranged from 39 to 79 (median 62) years and all were male. A total dose of $66{\sim}70\;Gy$ (median 66 Gy) was delivered with a 6-MV linear accelerator in $6.5{\sim}7$ weeks. The median follow-up period was 63 months. $\underline{Results}$: The actuarial disease-free survival rate for the entire group of the patients was 79% at 5 years. The five-year disease-free survival rates for patients without and with subglottic extension were 90% and 56%, respectively (p=0.03). However, anterior commissure involvement, supraglottic extension, and impaired cord mobility were not statistically significant prognostic factors. The five-year disease-free survival rates for patients with and without concurrent chemotherapy were 86% and 69%, respectively (p=0.47). $\underline{Conclusion}$: Subglottic extension can be considered a poor prognostic factor for T2N0 glottic cancer.

Calcifying Aponeurotic Fibroma - A Case Report - (석회화 건막 섬유종 - 증례 보고 -)

  • Paik, Seung-Sam;Jang, Ki-Seok;Han, Hong Xiu;Kim, Hyung-Jong;Roh, Won-Il;Lee, Seong-Pil;Lee, Kwang-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.233-237
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    • 2003
  • Calcifying aponeurotic fibroma is a benign, aggressive fibrous tumor seen in childhood or adolescence that most commonly affects the palm. We report our experience in treating calcifying aponeurotic fibroma in the hand of fifteen-year-old boy. He was presented with a recurrent mass in hypothenar area of his left hand. He had a history of local excision of the mass 7 years ago in local clinic. The palpable mass was hard, tender and movable. The simple X-ray revealed multifocally scattered microcalcifications in the mass. The excised mass showed the features of dense fibrotic soft tissue tumor with multiple small whitish calcifications. The microscopic sections showed a lobulated and a poorly circumscribed proliferation of dense fibrous tissue, containing islands of metaplastic chondroid differentiation with prominent calcification. The recommended treatment of this lesion is wide excision allowing for sparing of functional or vital structures, but high recurrence rate as this case has been reported to be more than 50 percent.

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A New Technique of Angioplasty of the Left Pulmonary Artery Using an Autologous Main Pulmonary Artery Flap (활로 4징 환자에서 자가 주폐동맥 플랩을 이용한 새로운 좌폐동맥 성형술)

  • 이창하;전양빈;이택연;이석기;백만종;김수철;이영탁
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.255-260
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    • 2003
  • Background: Stenosis of the left pulmonary artery (LPA) after repair of tetralogy of Fallot (TOF) is troublesome. A new technique of LPA angioplasty using an autologous MPA flap was performed in patients with TOF Material and Method: From October 1998 to January 2001, 24 patients (median age; 10 months, range; 4 to 145 months) underwent total correction of TOF with LPA angioplasty using the autologous MPA flap. Five patients underwent pulmonary angioplasty without any patch over the MPA and LPA. The patches were required to enlarge only the MPA in 4 patients, and transannular RVOT widening was performed in 15. Result: There were no operative or late deaths. During follow-up (range: 6~42 months), reoperation for LPA stenosis was not required in any patients, but balloon angioplasty for branch pulmonary artery stenosis was performed in 3 patients. Echocardiography and CT angiography at the recent follow-up showed an obtuse angle between the MPA and LPA. Conclusion: Although further follow-up is needed, the angioplasty using the autologous MPA flap can be easily performed, avoiding patch-related complications, and allowing growth of the MPA flap. This angioplasty technique creates a more natural and obtuse angle between the MPA and LPA, which can minimize kinking of the LPA, especially in the patients who underwent transannular patch widening.

Placement of an Intraocular Silicone Prosthesis with Evisceration in a Dog with Refractory Glaucoma (난치성 녹내장을 지닌 개에서 안구내용제거술을 통한 안구 내 실리콘 보철물 적용 1례)

  • Kim, Kyung-Hee;Kim, Joon-Young;Choi, Young-Min;Lee, Jong-Hoon;Park, Chang-Hee;Lee, Jung-Ha;Lee, Young-Sun;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.610-613
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    • 2010
  • An 8-year-old male dog weighing 7.9 kg was referred to us for evaluation of exophthalmos and corneal edema of the left eye, on which cataract surgery had been performed 3 years prior. On ophthalmic examination, the left eye showed an extremely high intraocular pressure (47 mmHg), with no menace response, dazzle reflex, or pupillary light reflex. The dog was treated with systemic and topical glaucoma medications. After treatment, corneal edema decreased but IOP did not return to within acceptable limits. Seventeen months later, the dog presented with hyphema, episcleral congestion, and corneal edema attributable to accidental trauma. The owner wished to maintain an attractive ocular appearance, and an intraocular silicone prosthesis (ISP) was thus inserted after the evisceration. Three months postoperatively, a corneal ulcer was detected, but this resolved successfully after prescription of appropriate medication. One year after surgery, no complications related to surgery were evident.

Bronchoplastic Procedures in Patients with Benign Bronchial Stenosis ann'Obstruction -Review of 13 cases- (양성 기관지 협착 및 폐쇄환자에서의 기관지 성형술 -13례 보고-)

  • 조건현;조민섭
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1366-1372
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    • 1996
  • Bronchoplasty has gained popularity in the selected cAses of bronchogenic carcinoma with poor pulmonary reserve, and also has been a choice of treatment for obstructive bronchial diseases since it can cure patient completely with preservation of pulmonary function. From Apr. 1990 to hpr. 19'96 two methods of bronchoplastic procedures, d patch dilating bronchoplasty and a segmental bronchial resection with end-to-end anastomosis, were performed with or without concominant pulmonary resection in 13 patients with benign bronchial stenosis and obstruction. The patients were 8 men and 5 women with average age of 43years(range 19 to 64 years). Patch dilating bronchoplasty using autogenous perichondrium and pericardium was applied in 5 cases of bronchial stenosis. Antecedan diseases of bronchial stenosls were 3 inflammatory bronchiectas is, and 2 endobronchial tuberculose is mixed with bronchi,ectas is. Segmental bronchial resection with end-to-end anastomosis was applied in 8 cases of bronchial obstruction, which were caused by endobronchial tuberculosis in 6 and cicatrization after trauma and foreign body in one case each. Bronchial obstructive symptoms and signs including recurrent pulmonary infection, dyspnea and wheezing were disappeared postoperatively with satisfactory recovery of physical activity. There was no operative mortality. Morbidity occured in 2 patients which were one case of unstability of applied bronchial patch resulting atelectasis and one case of bronchial restenosis at the anastomotic site. Based upon our experiences, we conclude that bronchoplastic procedure can be done with great success in patients with lung atelectasis caused by bronchial obstruction or stenosis and it restores physiologic function of collapsed lung with acc ptable complication.

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Slit Ventricle Syndrome in Children : Clinical Presentation and Treatment (소아에서 틈새뇌실 증후군 : 임상 양상 및 치료)

  • Shin, Beom-Sik;Yang, Kook-Hee;Kim, Dong-Seok;Choi, Joong-Uhn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.309-315
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    • 2001
  • The term slit ventricle syndrome(SVS) refers to an episodic occurrence of headache, vomiting, and possibly some degree of impaired consciousness in shunted hydrocephalic children in whom slit-like ventricles are seen on CT scan or MRI. Authors present 6 cases with SVS who were treated at our institute for last 10 years. From 1986 to 1996, 821 patients underwent shunt surgery for hydrocephalus. The etiology of hydrocephalus included brain tumor(140 patients), post-hemorrhagic(62 patients), idiopathic normotensive hydrocephalus(64 patients), post-meningitic( 58 patients), post-traumatic(54 patients), congenital(48 patients), neurocysticercosis(31 patients), and unknown etiology(364 patients). During the mean follow-up duration of 68 months, 232 shunt revisions were performed by a revision rate of 1.28 per patient. The incidence of SVS was 0.7%(6 patients). Most of them have been operated on in infancy. Time interval from the first operation to the development of slit-ventricle syndrome ranged from 4 to 8 years, the mean was 6 years. Shuntogram showed patent shunt in all patients. Two patients with less severe clinical symptoms improved with conservative treatment. These patients were not measured ICP because of good hospital course. One patient showed high ICP and needed only revision with same pressure valve as previous shunt. Low ICP was noted in 3 patients. Pressure augmentation using an anti-siphon device(ASD) or upgrading valve system were necessary in these patients. The authors stress that determining type of SVS is the first step in treatment planning and that the best treatment is a strategy aimed at resolving the specific type of SVS responsible for the symptoms.

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