• Title/Summary/Keyword: 부분 절제술

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Arthroscopic Technique of Partial Meniscectomy for Bucket Handle Tear of Medial Meniscus using Posteromedial Portal (내측 반월상 연골판 양동이형 파열의 후내측 도달법을 이용한 관절경적 부분 절제술 - 수술 수기 -)

  • Ahn, Jin-Hwan;Lee, Jong-Yoon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.71-75
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    • 2000
  • Purpose : To introduce arthroscopic partial meniscectomy fur bucket handle tear of medial meniscus using posteromedial portal, which is superior to arthroscopic partial meniscectomy using standard anterior portals commonly used. Method : After arthroscopic examination of the knee, we reduce the torn meniscus, advance the arthroscope into posteromedial compartment under arthroscopic visualization, we make posteromedial portal with reexamination of the compartment and perform arthroscopic partial meniscectomy. Conclusion : With the technique of arthroscopic partial meniscectomy using standard anterior portals, accurate partial meniscectomy can not be done because of inadequate visual field, associated meniscal injuries of posterior horn and cartilage lesion of posterior aspect of the medial femoral condyle can be missed, commonly posterior cruciate ligament can be injured and artificial damage to weight bearing surface of medial femoral condyle is possible. An arthroscopic partial meniscectomy using posteromedial portal is an excellent method fur bucket handle tear of medial meniscus.

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The Causes of Reoperation after Meniscectomy of the Lateral Discoid Meniscus (원판형 연골 절제술 후 재수술의 원인)

  • Lim, H.C.;Shim, J.H.;Ha, H.S.
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.115-120
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    • 1999
  • Purpose : After the total or partial meniscectomy of the lateral discoid meniscus, many patients complain the residual pain or the recurrent symptoms of the meniscus, and some of them need reoperation. We analyzed the causes of the reoperation after initial meniscectomy. Material & Method : Two hundred seventy three patients with the symptomatic lateral discoid meniscus were treated by arthroscopic meniscectomy between October, 1989 and September, 1998. Of the 273 patients, 69 patients were treated by total meniscectomy and 204 patients were treated by partial meniscectomy. The male to female sex ratio was 1:1.04, and the average of the age was 23.1 years old(from 4 to 59 years old). The reoperation was done in 8 patients, of which 1 was the case of total meniscectomy at the initial operation, and the rest 7 were the case of partial meniscectomy. Results : Of the 8 reoperations, 3 patients recurred the meniscal symptoms within the 3rd week after the initial operation, and 5 patients recurred beyond the 3rd week after the initial operation. Among the 3 patients of carly recurrence, 2 patients showed inadequate sizes of the remnant meniscus, and 1 patient showed posterolateral instability of the remained meniscus. Among the 5 patients of late recurrence, 3 patients showed rerupture of the meniscus, and 2 patients showed associated pathology of degenerative arthritis following osteochondritis dissecans. Conclusions : The reoperation rate after initial meniscectomy of the lateral discoid meniscus was higher in partial meniscectomy than total meniscectomy. During the operation of the lateral discoid meniscus, we must determine the adequate resectional margin, confirm the remnant meniscus by probing, and look for the associated pathologies.

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Endoscopic Resection of Early Gastric Cancer in Korea: Recent Results and Future Directions (조기위암 내시경절제술-최근 국내 성적과 발전방향)

  • Lee, Jun-Haeng
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.39-45
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    • 2009
  • Endoscopic resection has been established as one of the treatment options for selected cases of early gastric cancer in Korea. Yet the indications, best treatment methods, management of complications and follow-up methods after the procedure are still uncertain. Some large-scale multicenter studies have recently been reported in Korea. In this review, I will provide an overview of the recent published articles and future directions for endoscopic resection of early gastric cancer.

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Early Tailoring Thoracoplasty in Patients Undergoing Pulmonary Resection (폐의 부분 절제시 조기 변형식 흉곽성형술의 임상적 의의)

  • Lee, Sam-Yun;Yang, Hyeon-Ung;Choe, Jong-Beom;Choe, Sun-Ho
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.396-401
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    • 1997
  • Tailoring thoracoplasty is employed prior to, following, or concomitant with pulmonary resection when it is anticipated that insufHclent lung tissue will remain to fill the pleural space following a pulmonary resection. This study reviewed a series of eight patients treated with tailoring thoracoplasty between 1990 and 1995. Indications were to close a persistent space In four patients and to tailor the thoracic cavity to accept diminished lung volume concomitant with a pulmonary resection in the other four patients. The primary underlying disease was lung cancer in three patients and pulmonary tuberculosis In five patients, two of whom had concomitant aspcrgilloma, two, pneumothora , and one, empyema with bronchopleural fistula. In four patients with a prior pulmonary resection, the tailoring thoracoplasty was performed within eight days after the resection surgery. There was no failure to accommodate the thoracic cavity to insufficient lung tissue, even though two patients needed a second thoracoplasty. We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural space and to accommodate diminished lung volume with acceptable cosmetic results Early, after, or concomitant with pulmonary resection in selected patients.

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Huge Intraabdominal and Thoracic Desmoid Tumor -Surgical experience in one case - (복강 및 흉강 내 거대 데스모이드 종양 수술 치험 1예)

  • 김경화;서연호;구자홍;김민호
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.623-626
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    • 2003
  • Desmoid tumors are benign neoplasms with high rates of recurrence. A case of huge desmoid tumor of the intrathoracic and intraabdominal space is presented. The patient was treated with resection, which involved hepatic left lobectomy and diaphragmatic resection and partial pericardiectorny and wedge resection of left lower lobe of lung. The resulting defect over the pericarium and diaphragm was reconstructed by bovine pericardium and Marlex mesh. Prevention of presumed local recurrence of desmoid tumors requires wide excision margin.

Changes of Specific Activity and Regulation of Nitric Oxide Synthase during Liver Regeneration after Partial Hepatectomy

  • Lee, Young-Jin;Nam, Suk-Woo;Seo, Dong-Wan;An, Sung-Whun;Ko, Young-Kwun;Sung, Dae-Seok;Han, Jung-Whan;Lee, Hyang-Woo
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.185-185
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    • 1996
  • Nitric oxide synthase(NO Synthase:E.C.1.14.13.39)는 생체내에서 L-arginine을 기질로 하여 citrulline과 nitric oxide(NO)를 생성하는 효소로서, 최근 연구에 의하면 2/3 부분 간 절제술 후 prereplicative phase동안에 발현되는 것으로 알려져 있다. 한편, 생체내에서 NO Synthase에 상경적 길항제인 methylarginine에 관해서도 수년간 많은 연구가 진행되어 왔다. 이들의 생성 기전은 protein methylation에 의해 생성된 methylated protein이 생체 내에서 분해되어 생성된다고 알려져 있으나, 정확한 기전에 대해서는 아직 논란의 여지가 많다. 따라서, 본 연구에서는 In vivo 실험을 통해 부분 간 절제술 후 시간대별로 간 조직에서의 NO Synthase 활성도와 혈청에서 NO의 최종 대사물인 Nitrite/Nitrate를 측정하였으며, 또한 NO Synthase 조절에 관여하는 세포내 기질인 arginine과 억제 인자인 methylarginine함량을 간 조직 및 혈청에서 측정하고, 세포 신호 전달체계에 관여하는 cyclic GMP 함량을 측정함으로써, 부분 간 절제술 후 간 재생동안에 NO Synthase 활성도와 methylarginine 및 arginine과의 상관 관계를 규명하고, 간 재생동안, 생성된 nitric oxide의 역할을 연구하려한다.

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Prosthetic rehabilitation of partially edentulous patient after maxillectomy: A case report (상악골 부분절제술 시행한 부분 무치악 환자에서 폐쇄 장치를 이용한 보철 수복 증례)

  • Heo, Kyung-Hoi;Lim, Young-Jun;Kim, Myung-Joo;Kwon, Ho-Beom
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.2
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    • pp.167-171
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    • 2016
  • Patients undergone partial maxillectomy experience post-operative masticatory, phonetic, and swallowing difficulties. They also encounter social and psychological challenges due to changes in their facial appearances. Thus, functional and esthetic recovery through maxillofacial prosthesis becomes significant for these patients. The objective of an appropriate obturator is to restore palate and improve phonetic and swallowing ability by separating the oral cavity, nasal cavity, maxillary sinus, and nasopharynx. In this case report, an obturator was fabricated for a patient who had partial resection from the maxillary posterior region to the pharynx due to squamous cell carcinoma. The purpose of this case study is to describe the results because the patient was successfully improved both functionally and esthetically.

A case of Obturator using Swing-lock Attachment for Par tial Edentulous Patient with Hemi-Maxillectomy Patient (Hemi-Maxillectomy 부분무치악 환자의 Swing-Lock Attachment를 이용한 Obturator 수복 증례)

  • Oh, Byung-Doo;Lim, Jong-Hwa;Shin, Soo-Yeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.1
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    • pp.33-38
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    • 2010
  • Maxillectomy is a treatment option for maxillary cancer, which leaves the patient with a palatal defect. It may cause problems with facial deformation, swallowing, mastication, and speech. These functional problems and changes in appearance may result in psychological problems. To control these deficits after maxillectomy, surgical reconstruction or prosthodontic treatment can be chosen as a treatment option. Obturator prosthesis has been used as a preferred method of rehabilitation for most maxillectomy patients. This case is a patient who was classified Aramany classification II hemi-maxillectomy patient with residual teeth from #11-25, whose teeth had substantial labioversion and clinically lengthened from alveolar bone involution, thus making it hard to select proper framework design and resist to the rotational dislodging force of the obturator. Therefore we selected swing-lock attachment design to remain pre-existing crown and bridges and obtain retention and stability of obturator. The swing-lock RPD is economical than the conventional RPD because we can remain pre-existing crown and bridges. And residual teeth which have mobility and poor prognosis can be successfully retained through properly designed swing-lock RPD as it is functioning as a removable splint on the teeth.

Partial Left Ventriculectomy in the Pediatric Patient with Dilated Cardiomyopathy (확장성 심근증 환아에서의 부분 심실 절제술의 적용 -1례 보고-)

  • Yoo, Jeong-Woo;Park, Pyo-Won;Jun, Tae-Gook;Park, Kay-Hyun;Chae, Hurn;Lee, Heung-Jae;Kang, Yi-Suk
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.299-302
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    • 1999
  • Heart transplantation was planned for a 10-year old boy who had dilated cardiomyopathy with severe congestive heart failure and had been on dopamine for 1month. However, partial left ventriculectomy and mitral annuloplasty were performed instead, because there was no donor heart of the adequate size and the symptoms were aggravated. The clinical symptoms were markedly improved after the surgery. Comparing the postoperative echocardiographic results with the preoperative results, there were remarkable changes in the left ventricular ejection fraction(preoperative LV EF 17% to postoperative 3 months 29%, 6 months 35%, 1 year 36%) and the left ventricular end-diastolic dimension(preoperative 72 mm to postoperative 3 months 59 mm, 6 months 61 mm, 1 year 61 mm). Partial left ventriculectomy and mitral annuloplasty reduced the cardiac loading in the dilated cardiomyopathy. Partial left ventriculectomy and mitral annuloplasty may be considered as one of the alternative surgical metho s to carry over until a heart transplantation can be performed, especially for children.

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Diagnosis and Treatment of Gastric Cancer (위암의 진단과 치료)

  • Song, S.K.
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.173-181
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    • 1996
  • 위암 환자의 수술후 5년 생존율은 조기암의 경우 90%이상으로 매우 좋으나 진행암의 경우 20~30%를 넘지 못한다. 위암의 예후에 영향을 주는 요인 중 조기 발견보다 더 중요한 것은 없으며, 조기암의 진단율에 노력을 기울이는 것이 현실적 타개책이라 하겠다. 현재 우리나라의 조기암 진단율은 16~22%로 일본의 40~45%보다 극히 저조하므로 소화기계 증상이 있는 경우 위내시경 검사를 적극 권고함이 바람직하다. 위암은 외과적 절제술이 유일한 근치치료법임은 주지의 사실이며 근래에는 위내시경 및 복강경을 이용하여 위장관 기능을 보존하는 술식도 시도되고 있어 바람직한 발전이라 사료되나, 림프절 곽청의 원칙을 훼손하지 않는 범위내에서 이루어져야할 것이다. 근치적 절제술의 정의에 합당한 외과적 치료법만이 5년 생존율 향상을 기대할 수 있으며, 보조적 항암화학요법과 면역요법은 대상 환자의 엄선으로 부분적 치료효과를 기대할 수 있다. 절제불능 위암이나 국소진행암에서 절제율을 높이기 위한 술전치료방법들의 적극적 도입이 바람직하다. 그러나 대상 환자의 선정에 있어 객관적 타당성이 있는 병기 결정 방법과 치료효과를 판정하는 방법의 혁신이 있어야 할 것으로 사료되며 현재의 부정확한 검사방법들의 대안으로 복강경의 이용이 바람직하리라 사료된다.

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