• Title/Summary/Keyword: 보존적수술

Search Result 498, Processing Time 0.03 seconds

Growth Characteristics and Vegetation Structure of the Pinus densiflora Forest for Sugumagi of Unmun Temple, Cheongdo-gun, Korea (청도군 운문사 입구 수구막이 소나무림 식생구조 및 생육 특성)

  • Kang, Gi Won;Lee, Do-I;Han, Bong-Ho;Kwak, Jeong-In
    • Journal of the Korean Institute of Landscape Architecture
    • /
    • v.48 no.5
    • /
    • pp.1-15
    • /
    • 2020
  • This study was designed to come up with a way of managing a cultural landscape forest by conducting research on the vegetation structure and growth characteristics. This study's target site, which was 45,201㎡ in size, was Pinus densiflora forest for Sugumagi placed at the entrance of Unmun Temple, Sinwon-ri, Unmun-myeon, and Cheongdo-gun in the southernmost part of Gyeongsangbuk-do, Korea. Sugumagi means the water of the valley flows far away, and where no downstream is visible according to feng shui. The historical sources of the Sugumagi Pinus densiflora forest at the entrance of Unmun Temple isn't clear. It waw only found at that location. The Pinus densiflora forest at the entrance of Unmun Temple is located in the waterway in terms of Feng Shui. The present condition of growth was investigated through a grid surveys of 98 trees and Pinus densiflora growth. As a result of the analysis of growth status, Pinus densiflora, Larix leptolepis, Zelkova serrata, Celtis sinensis, and Rhus javanica were distributed in the conopy layer, and 28 species including Ailanthus altissima were grown in the understroy layer, and 92 species, including Ampelopsis brevipedunculata, in the shrub layer. The plant community structure was divided into low, medium and high-density Pinus densiflora forests in the study area, based on the number in the conopy layer and the grade of and the trees analyzed. As a result of the analysis, the Pinus densiflora dominated the low, medium and high-density Pinus densiflora forests, and there were no competitive species. The relative dominance of the low-density Pinus densiflora forests was 46.9% on average, medium-density was 62.6% and 50.2% was found in high-density. The mean species diversity of Shannon in the low-density study was 0.7055, medium-density study was 0.8966 and the average species diversity of Shannon in the high-density study was 0.8317. The analysis of the age and growth of 25 sample trees in the Sugumagi Pinus densiflora forest shows that the distribution of the chest diameter (DBH) of the sample Pinus densiflora is 38 to 77cm with the average chest diameter being 61.1cm. The age was 84-161 years and the average was 114 years. In the Pinus densiflora forest, most(670,659, or 98.3%) of the tree trunk wound was collected for rosins during the Japanese colonia Era, Of the total 670, 659 were Pinus densiflora, 98.3% of the total. 394 were surgically repaired in 2005. For the preservation of the Sugumagi Pinus densiflora forest, dead trees should be replaced with substitute trees appropriate to the middle and south topography. It is demanded that foreign species such as Larix leptolepis in the research area should be removed and Pinus densiflora that underwent surgical operations should be regularly sterilized. It is also emphasized that the management of insecticide is important.

Is Skeletonized Internal Mammary Artery Harvesting better than Pedicled Harvesting in Respect of the Sternal Blood Flow\ulcorner: An Estimation Using Bone Scan (내유동맥의 골격화 채취는 흉골로의 혈류 감소 측면에서 과연 유리한가 \ulcorner: 골주사를 이용한 평가)

  • 손국희;김영삼;김정택;윤용한;김광호;최원식;백완기
    • Journal of Chest Surgery
    • /
    • v.37 no.6
    • /
    • pp.511-516
    • /
    • 2004
  • Background: One of the theoretical advantages of skeletonized internal mammary artery harvesting in coronary artery bypass surgery is to minimize the interruption of the sternal blood flow inevitably accompanied by internal mammary harvesting. A study using bone scan is designed to determine the effects of internal mammary artery harvesting technique on the sternal blood flow. Material and Method: From April 2002 to March 2003, 27 patients out of 48 patients who underwent the isolated coronary bypass surgery were enrolled into the study. The enrolled patients underwent bone scan in the preoperative period and postoperative period respectively. Bilateral internal mammary artery was used in 8 patients (BIMA group) and single left internal mammary artery in 19 patients (LIMA group). The patients in LIMA group were divided into two groups: LlMA_skel group, in whom left internal mammary artery was harvested in skeletonized fashion (n=12), and LlMA_ped group, in whom left internal mammary artery was harvested in pedicled fashion (n=7). After the bone scan, the region of interest (ROI) was created on the left of the sternum and the mirror image with the same pixel numbers was placed on the right half of the sternum. The mean counts per pixel on the left side of the sternum was compared with those on the right side and expressed as left to right ratio (L/R ratio). Result: In LIMA group, the L/R ratio decreased from 94.6$\pm$4.1% to 87.9$\pm$6.9% (p=0.003) after the operation as compared to BIMA group, in which no change of the L/R ratio was observed. The changed of the L/R ratio in LlMA_skel group and LlMA_ped group were from 95.3$\pm$4.2% to 88.3$\pm$7.7% and from 93.4$\pm$3.9% to 87.4$\pm$5.8% respectively. The % changes in L/R ratio were -7.44 $\pm$7.08 in LIMA_skel group and -6.17$\pm$9.08 in LiMA_ped group, which did not reach the statistical difference. Conclusion: Ipsilateral sternal blood flow is interrupted by internal mammary artery harvesting as evidenced by the decrease in L/R ratio after left internal mammary artery harvesting irrespective of the harvesting techniques. Skeletonized harvesting did not show superiority in respect to sternal blood flow as compared to pedicled harvesting.

Saddle Prosthesis (안장형 인공 고관절 전치환술)

  • Park, I.H.;Ihn, J.C.;Lee, J.M.
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.1 no.2
    • /
    • pp.133-144
    • /
    • 1995
  • After resection of intraarticular, periacetabulum(P2) and pubic rami(P23) and extraarticular, proximal femur(P2-H12) by Enneking classification, reconstruction is very difficult. We experienced three cases of saddle prostheses for reconstruction after P2, P23, and P2-H12 resection in pelvic malignancies. Case 1 was a high grade chondrosarcoma in 36 year-old-man and P2 resection was done. But he died of disease 19 months after operation. Case 2 was a malignant giant cell tumor in 32 year-old-woman. P23 resection was given and she is disease-free 32 months after operation. Case 3 was an osteosarcoma of 27-year-old-man and P2-H12 resection was performed and he is disease-free postoperative 12 months now. According to MSTS functional evaluatin system, all three patients showed no pain(5), intermediate function(2), emotinally satisfied(3), one cane or crutch supported(1), limited walking(3), and minor cosmetic gait(3). There was no significant complication and no dislocation except intermittent inguinal hernia in case 2. All patients started crutch walking 3 weeks after operation. Around 6 months postoperatively, the preserved iliac wing(P1 component) was hypertrophied enough to endure the full weight bearing. All could have squating and kneeling positions. In conclusion, saddle prosthesis would be a very useful method of reconstruction after P2, P23, and/or H1-2 resection to shorten the operation time and to reduce the infection rate without significant loss of function.

  • PDF

Treatment of Traumatic Carotid-Cavernous Fistulas using Debrun's Detachable Balloons (Debrun분리 풍선 카데타법에 의한 경동맥 해면동루의 치료)

  • Lee, Sang-Jin;Kim, Sun-Yong;Hwang, Mi-Soo;Chang, Jae-Chun;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
    • /
    • v.6 no.2
    • /
    • pp.91-101
    • /
    • 1989
  • The goal of therapy in patients with traumatic carotid-cavernous fistulas is to occlude the fistula, preferably while maintaining the carotid blood flow. Since the introduction of the concepts of detachable balloon technique to occlude arteriovenous fistulas, the technique has become the treatment of choice in the management of traumatic carotid-cavernous fistulas. The major symptoms of traumatic CCFs are (1)pulsating exophthalmos, (2)orbital and cephalic bruit and murmur, (3) headache, (4) chemosis. (5) extraocular palsies, and (6) visual failure. Traumatic CCFs are combined with multiple associated lesions. We tried the occlusion of fistulas using Goldvalve balloons in 8 consecutive cases of traumatic CCF and the result of our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases and the fistulas was successfully occluded in all cases. In 5 cases. the internal carotid artery was preserved and the arterial lumen was occluded along with fistula opening in :3 cases. In one case, surgical ligation was done because of symptoms recurred and incomplete occlusion of fistula. We experienced hemiparesis as a major complication in one case during occlusion tolerance test, which was remitted spontaneously. The results of Debrun balloon treatment were relatively excellent. We consider that the first choice of treatment of traumatic CCF is occlusion of the fistula by a detachable balloons.

  • PDF

A Case of Rectus Sheath Hematoma and Intraperitoneal Hematoma Induced by Cough (기침으로 유발된 복직근초 혈종 및 복강내 혈종 1예)

  • Jeong, Hae Bin;Kang, Hyeon Hui;Im, Eun Joo;Kim, Hyun Gyung;Lee, Su Yeon;Maeng, Il Ho;Lee, Ji Myoung;Jang, Eun Hee;Lee, Sang Haak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
    • /
    • v.65 no.3
    • /
    • pp.212-215
    • /
    • 2008
  • Rectus sheath hematoma (RSH) is a rare condition that's caused by a sudden disruption of the deep epigastric vessels or direct damage to the rectus abdominis muscle. This condition is associated with old age, childbirth, abdominal surgery, severe cough, severe sneezing, anticoagulation therapy and/or coagulation disorders. RSH is characterized by abdominal pain and an abdominal mass, so that this is often misdiagnosed as a surgical condition such as appendicitis, intraabdominal abscess, torsion of the ovary and ruptured abdominal aortic aneurysm; this can lead to unnecessary surgery. Thus, we have to be cautious not to miss RSH when a patient with predisposing factors is suffered from abdominal pain and an abdominal mass. We report here on a case of rectus sheath hematoma that was induced by severe cough in a patient who was taking warfarin.

Clinicopathologic Characteristics of and Surgical Strategy for Patients with Submucosal Gastric Carcinomas (위 점막하층암의 임상병리학적 특징과 수술 방법)

  • Park Chan Yong;Seo Kyoung Won;Joo Jai Kyun;Park Young Kyu;Ryu, Seong Yeob;Kim Hyeong Rok;Kim Dong Yi;Kim Young Jin
    • Journal of Gastric Cancer
    • /
    • v.5 no.2
    • /
    • pp.89-94
    • /
    • 2005
  • Purpose: Early gastric cancer (EGC) has an excellent prognosis compared to advanced gastric cancer. The 5-year survival rate for EGC now exceeds $90\%$, and EGC is recognized as a curable malignancy. The important prognostic factor in EGC is the status of lymph-node metastasis. Despite conserving surgery being suggested for EGC at present, it is of vital importance to select a surgical method appropriate to each individual case. This retrospective study was undertaken to clarify clinicopathologic features and factors related to lymph-node metastasis in submucosal gastric cancer in order to determine an appropriate therapy. Materials and Methods: This study analyzed the clinicopathologic features for 279 patients with a submucosal gastric carcinoma (Group I) and compared with those of patients with mucosal (Group II) or muscularis proprial gastric carcinoma (Group III). All patients were operated on from 1981 to 1999 at Chonnam University Hospital. There were no statistically significant differences among the groups with respect to age, gender, tumor location, hepatic metastasis, or peritoneal dissemination. Results: Positive lymph node metastasis was found in 47 ($16.8\%$) of the 279 patients with a submucosal gastric carcinoma. The incidence of lymph-node metastasis was significantly higher in patients with a submucosal gastric carcinoma than in patients with a mucosal gastric carcinoma ($16.8\%\;vs.\;3.9\%\;$; P<0.01). Therefore, depth of invasion was a significant factor affecting in lymph-node metastasis. The 5-year survival rates were $88.6\%$ for patients in Group I, $95.2\%$ for patients in Group II, and $72.7\%$ for patients in Group III (P<0.01 for Group I vs. Group II; Group I vs. Group III). In patients with a submucosal gastric carcinoma, the survival rate with positive lymph nodes was significantly poorer than that of patients without lymph-node metastasis ($87.3\%\;vs.\;94.2\%$; P<0.01). Conclusion: Gastrectomy with D2 lymph node dissection is an appropriate operative procedure for patients with a submucosal gastric carcinoma.

  • PDF

Comparative Analysis of T2 Selective Division of Rami-communicantes (Ramicotomy) to T2 Sympathectic Clipping in Treatment of Craniofacial Hyperhidrosis (안면 다한증에서 T2 Sympathetic Clipping과 T2 Ramicotomy의 비교 연구)

  • 김도형;백효채;강두영;전세은;이두연
    • Journal of Chest Surgery
    • /
    • v.37 no.3
    • /
    • pp.267-271
    • /
    • 2004
  • Compensatory sweating is the main cause of patient dissatisfaction after sympathetic surgery for craniofacial hyperhidrosis. Surgery that sympathetic nerve trunk preserved and extent of resection limited was introduced to decrease compensatory sweating. From Jan 2000 to July 2002, the vidio-assisted thoracoscopic T2 sympathetic clipping and rami comunicantes selective division were performed in 36 patients suffering from craniofacial hyperhidrosis. Twenty two patients underwent a T2 sympathetic nerve clipping (Group 1), and fourteen patients underwent division of the T2 ramicommunicates (Group 2). We retrospectively analysed the rate of satisfaction, dryness of face, the rate of compensatory sweating, grade of compensatory sweating. The dryness of face was that no statistical difference between group 1 and group 2 (p=0.387); group1: dry 22.7% (5/22), humid 77.3% (17/22) group 2: dry 14.3% (2/14), humid 78.5% (11/14), persist 7.2% (1/14). The rate of satisfaction was 77.3% in T2 clipping and 64.2% in T2 sympathicotomy with no significant in the statistic analysis (p=0.396). The rate of compensatory sweating on group 2 was lower than group 1 (p=0.042); 95.4% (21/22) in T1 sympathetic clipping and 71.4% in T2 ramicotomy. The rate of embarrassing and disabling compensatory sweating was 70.5% (embarassing 8 patients, disabling 9 patients) in T2 clipping and 42.9% (embarassing 8 patients, disabling 9 patients)in T2 ramicotomy with statistically significant difference (p=0.036). The sympathetic trunk preservation surgery for craniofacial hyperhidrosis (T2 ramicotomy) redueced the rate of compensatory sweating when compared to the blocking surgery of sypathetic trunk (T2 clipping).

Current trends in orthodontic patients in Seoul National University Dental Hospital (서울대학교 치과병원 교정과에 내원한 부정교합 환자의 최근 경향)

  • Im, Dong-Hyuk;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
    • /
    • v.33 no.1 s.96
    • /
    • pp.63-72
    • /
    • 2003
  • Over the Past decades, the number of Patients seeking orthodontic treatment has increased markedly with socioeconomic development and change of recognition on appearance. The purpose of this study was to provide an epidemiologic data base related to the orthodontic treatment need. We could take an adequate information regarding the characteristics of orthodontic patients, and the changing trends about treatment mordality. Distrubution and treands were Investigated in 676 patients who had been examined and diagnosed at Department of orthodontics, Dental Hospital, Seoul National University from January to June in 1992 and 2002. 1. Sex distribution of patients changed from 1:2.1 to 1:1.5 (male female). 2. In 2002, are distribution had shown $7\~12$ year-old group being the largest$(32.0\%)$ and percentage of $19\~24,\;13\~18,\;over\;25,\;4\~6,\;0\~3$ year-old group were $24.0\%,\;21.6\%,\;14.2\%,\;5.8\%,\;2.4\%$ respctively. Compared with data in 1992, the number of adult patients highly increased. 3. With regard to Angle classification, each percentage of Class I, Class II div 1, Class II div 2, and Class III malocclusion were $25.0\%,\;20.9\%,\;3.4\%,\;and\;48.1\%$ respectively in 2002. 4. Geographic distribution showed that most of the patients visited $(37.0\%)$ lived in northeast of Seoul in 2002. 5. Mandibular prognathism showed the highest percentage in chief complaints. The percentages of crowding and facial asymmetry were $14.2\%\;and\;11.8\%$ in 2002. Patients with facial asymmetry increased significantly. 6. Percentages of patients treated with fixed appliance and orthognathic surgery were $38.0\%\;and\;25.0\%$ in 2002. Patients needed to observe the growth pattern comprised $13.0\%$ with increasing trends. The use of chin cap reduced and the percentage of ortognathic surgery and growth observation increased significantly.

Surgical Treatment of Metastatic Tumor in Proximal Femur with Recycling Autograft Prosthetic Composite after Wide Excision (근위 대퇴골 전이성 종양의 수술적 치료로서 광범위 절제술 후 재활용 자가골을 이용한 복합 고관절 성형술)

  • Kim, Jae-Do;Park, Pil-Jae;Kwon, Young-Ho;Jang, Jae-Ho;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.11 no.1
    • /
    • pp.71-81
    • /
    • 2005
  • Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

  • PDF

Risk Factors for Recurrence after Conservative Treatment in Early Breast Cancer: Preliminary Report (조기유방암에서 유방보존술 후 재발에 영향을 주는 인자)

  • Suh Chang Ok;Chung Eun Ji;Lee Hy De;Lee Kyong Sik;Oh Ki Keun;Kim Gwi Eon
    • Radiation Oncology Journal
    • /
    • v.15 no.4
    • /
    • pp.331-337
    • /
    • 1997
  • Purpose : To evaluate our experience in the breast-conserving treatment for early breast cancer with special regard to recurrence Pattern and related risk factors. Materials and Method :Two hundred and sixteen patients with AJC stage 1and 11 breast cancer who received breast conserving treatment between January 1991 and December 1994 were evaluated A9e distribution ranged from 23-80 year old with a median a9e of 44. One hundred and seventeen Patients had 71 lesions and 99 Patients had 72 lesions. Axillary lymph nodes were involved in 73 patients. All patients received a breast conserving surgery (wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Ninety six patients received chemotherapy before or after radiotherapy. Results : During the follow-up period (3-60 months, median 30 months), local recurrences were noted in six Patients (true: 3, elsewhere; 1, skin: 2). Sixteen patients developed distant metastases as the first sign of recurrence at 8-38 months (median 20 months) after surgery. Among them, three patients simultaneously developed local recurrence with distant metastases. Contralateral breast cancer developed in one Patient and non-mammary cancers developed in three patients. The actuarial 5 year survival rate was $88.4\%\;(stage\;I\;96.7\%,\;stage\;IIa\;95.2\%,\;stage\;IIb\;69.9\%)$. Age, I stage, number of involved axillary lymph nodes. and AJC stage were risk factors for distant metastases in univariate analysis. In the multivariate analysis, the number of involved axillary lymph nodes was the most significant risk factor for metastases. Conclusion : Local recurrence was not common in the early years after radiotherapy. Distant metastases occurred at a steady rate during the first three years and was more common in the Patients with larger tumors, higher number of involved axillary nodes, and younger age.

  • PDF