• Title/Summary/Keyword: 수술후 유착

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One Case of Nasal Surgery in Obstructive Sleep Apnea Syndrome (비강수술로 호전된 폐쇄성 수면무호흡증후군 1 례)

  • Choi, Ji-Ho;Lee, Heung-Man;Kwon, Soon-Young;Lee, Sang-Hag;Shin, Chol;Lee, Seung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.64-67
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    • 2005
  • Obstructive sleep apnea syndrome(OSAS) is a common disease in the field of otorhinolaryngology and is characterized by repeated upper airway occlusions occurring during sleep. OSAS can occur due to various etiologies of the nasal, oral, pharyngeal and laryngeal airway in adults. Nasal obstruction can be caused by septal deviation, nasal polyps, concha bullosa, choanal atresia, neoplasms, foreign body, postoperative/post-traumatic synechiae, various rhinitis and so on. There are various kinds of surgical treatment of OSAS including nasal surgery, LAUP, UPPP, surgery of tongue base, tracheostomy and so on, but the effect of nasal surgery on snoring and OSAS is controversial. The authors report the case of a patient who had experienced nasal obstruction, moderate snoring and OSAS and who improved after septoplasty and turbinoplasty.

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Implant Supported Fixed Restoration for Maxillary Edentulism using CAD/CAM Guided Implant Surgery (NobelGuide$^{TM}$) and Immediate Loading (상악 완전 무치악 환자의 CAD/CAM 을 이용한 임플란트 식립(NobelGuide$^{TM}$) 및 즉시하중 후 고정성 보철수복 증례)

  • Huh, Yoon-Hyuk;Yi, Yang-Jin;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.4
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    • pp.423-439
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    • 2012
  • This case report described a technique utilizing a computer-aided design (CAD)/computer-aided machining (CAM) - guided surgical implant placement and prefabricated temporary fixed prosthesis for an immediately loaded restoration. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla received 8 implants in maxilla using CAD/CAM surgical templates. Prefabricated provisional maxillary implant supported fixed prosthesis were connected immediately after implant installation. Provisional prosthesis was evaluated for aesthetics, function during 6 months. Definitive implant supported fixed porcelain fused metal bridges were fabricated.

THE TREATMENT OF CONGENITAL LYMPHANGIOMA WITH OK-432$(Picibanil^{(R)})$ AND SURGICAL EXCISION (OK-432$(Picibanil^{(R)})$와 외과적 절제술을 이용한 선천성 림프관종의 치험례)

  • Kim, Il-Kyu;Lee, Seong-Ho;Oh, Seong-Sub;Choi, Jin-Ho;Oh, Nam-Sik;Kim, Wang-Sik;Rim, Young-Il;Yang, Dong-Whan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.281-288
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    • 2001
  • Lymphangiomas are relatively rare benign tumors of the lymphatic system, characterized by congenital lymphatic malformation such as anastomosis or obstuction of the lymphatic channels. There are most frequently diagnosed in children younger than 3years. In contrast to that of the hemangioma, the sex distribution of the lymphangioma is nearly evenly divided. The head and neck lymphangioma represents about $70{\sim}75%$ of all lymphangiomas, and they are difficult to manage. Spontaneous regression is rare, and rapid intermittent enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequelae such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosants. Problems associated with surgical excision include the risk of cosmetically unacceptable scarring and the risk of damage to surrounding vital stricture and the high risk of incomplete excision. The sclerosants previously used have numerous other local and systemic side effects. This report describes a case that was successfully treated using OK-432 as a new sclerosant drug and secondary surgical excision for congential cavenous lymphangioma extensively enlarged to tongue, mouth floor and submandibular region.

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Video Assisted Thoracic Surgery of Spontaneous Pneumothorax (비디오 흉강경을 이용한 자연성 기흉 수술)

  • Ryu, Ji-Yun;Kim, Seung-U;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.512-516
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    • 1997
  • We have experienced 66 cases of video assisted thoracic surgery(VATS) of spontaneous pneumothorax. The patients ranged in age from 1 Syears to 46years(mean age, 22.3years) and male patients were sixty three. The indications of video assisted thoracic surgery of spontaneous pneumothorax were recurrence, continuous air leakage, visible blabs on the chest X-ray & others. Infraoperative findings were as follows; blabs, pleural adhesion and pleural effusion. The operation was performed under general anesthesia wit double lumen endobronchial tube. Operative procedures included blebectomy and/or wedge resection of lung, vibramycin Pleurodesis with mechanical abrasion. In most cases, postoperative courses were uneventful and patients were discharged without significant complications. VATS provided the benefits of lesser postoperative pain, rapid recovery, short hospitalization, and smaller scar of wound. Conclusively VATS is a new interesting modality of surgical treatment of spontaneous pneumothorax and also can be extensively applicable in the diagnosis and treatment of other intrathoracic disease.

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Occlusion of the Right Coronary Artery Ostium due to Rheumatic Aortic Valve Stenosis (류마티스성 대동맥 판막협착증에 의한 우관상동맥 개구부 폐쇄)

  • Seo, Hong-Joo;Oh, Sam-Se;Kim, Jae-Hyun;Kim, Soo-Cheol;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.445-447
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    • 2007
  • Occlusion of a coronary artery ostium and especially occlusion of the right by an aortic cusp is a rare condition. We experienced an adult patient with occlusion of the right coronary ostium that was due to fusion of the right coronary cusp to the aortic wall along with underlying rheumatic aortic valve stenosis. During the operation, the adherent right coronary cusp was excised. After confirming that the right coronary ostium was patent, the other cusps were removed, and this followed by replacement of the aortic valve with a mechanical valve. The postoperative course was uneventful.

Surgical Treatment for Chronic Peptic Ulcer with Gastric Outlet Obstruction (만성 소화성 궤양에 합병된 위출구 폐색의 수술적 치료)

  • Lee, Jei Hee;Yang, Shi Joon;Jeon, Young Woong;Park, Sei Hyeog;Kim, Jong Heung;Park, Jong Min
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.160-165
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    • 2008
  • Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

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Intestinal Strangulation Associated with Pubic Fracture in a Dog (개에서 치골골절과 연관된 장폐색)

  • Lee, Jae-Il;Kim, Young-Suk;Jeong, Seong-Mok;Kim, Myung-Jin;Park, Chang-Sik;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.458-460
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    • 2006
  • A 2-year-old female, 3.8kg weight, mixed-breed dog was presented for a 10-day history of vomiting and anorexia. The dog was diagnosed with pelvic fracture by vehicular accident at a local animal hospital before 2 months, but fracture did not reconstructed. After 2 months, the dog suffered from intermittent vomiting and anorexia. On barium contrast, we diagnosed the dog as intestinal obstruction. Consequently, we were found obstruction by strangulation and adhesion of intestine at the fracture site through the operation. At present after 18 months of surgery, general physical condition of the dog is good.

Surgical Correction of Peritoneopericardial Diaphragmatic Hernia with Hepatic Necrosis in a Himalayan Cat (히말라얀 고양이에서 간괴사를 동반한 복막심낭횡격막 허니아의 외과적 치료)

  • Kim, Joon-young;Jeong, Soon-wuk;Park, Bo-yeon;Go, Hiw-gon;Yoon, Hun-young;Jeong, Man-bok;Han, Hyun-jung;Min Hwang;No, Byung-kuk
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.45-48
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    • 2004
  • A five months old, female Himalayan cat was referred to the Veterinary Medical Teaching Hospital at Konkuk University, because of suspecting peritoneopericardial diaphragmatic hernia (PPDH). After consecutive examination, the patient was diagnosed as PPDH and hepatic dysfunction. In spite of medical therapy for a month, the serum chemistry profiles for liver enzymes (aspartate transferase: 469 U/L, alanine transferase: above analysis, gamma-glutamyl transferase: above analysis) did not decrease to the normal range. In operation, some of liver was necrotized and was adhesive to diaphragm, these were gently dissected from thoracic structures, and resected. After debriding, the edges of the defect of diaphragm were closed with a simple continuous suture pattern. One month after operation, the cat had normal condition, recovery was uncomplicated, and the serum chemistry profiles for liver enzymes decrease to the normal range.

Analysis of Neonatal Gastrointestinal Diseases in a Neonatal Intensive Care Unit for 3 Years Neonatal GI Diseases in a NICU for 3 Years (3년간 단일기관 신생아실의 위장관 질환의 분석)

  • Kwon, Kyoung-Ah;Bae, Mi-Hae;Park, Kyung-Hee;Byun, Shin-Yun;Cho, Yong-Hoon;Kim, Hae-Young;Sung, Si-Chan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.337-344
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    • 2011
  • Purpose: To report our experience of gastrointestinal operations performed in neonates including low birth weight infants and to evaluate their clinical characteristics. Methods: We retrospectively reviewed the medical records of patients who underwent neonatal gastrointestinal surgery or had necrotizing enterocolitis (NEC) or inguinal hernia from January 2008 to December 2010 at Pusan National University School of Medicine. Results: The main disease was anorectal malformation and male patients were dominant. Twenty four patients (19.2%) had one or more associated anomalies including hydronephrosis and congenital heart disease. Eighteen patients (43.9%) of anorectal malformation had other anomalies. Seventy six percent of NEC cases were very low birth weight infants. Concerning mean days of full enteral feeding after operation, NEC patients needed 30.8 days, which was the longest period. Overall mortality of operation (except NEC and inguinal hernia operation) was 1.6%. The mortality of NEC with surgical treatment was 18.8%. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC patients. Conclusion: The morbidity and mortality after neonatal gastrointestinal surgery were excellent. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC.

Arthroscopic Treatment of Tibial Spine Fracture using Suture Hook and pull-out PDS (Suture Hook과 pull-out PDS를 이용한 경골극 골절의 관절경적 치료)

  • Lee, Young Kuk;Kim, Joon Seok;Sohn, Sung Won
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.132-137
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    • 1999
  • Displaced tibial spine fractures need the anatomical reduction of the displaced bone fragment to achieve normal range of motion and anterior stability of the knee joint. The purpose of this paper is to describe details of arthroscopic technique using suture hook and pull-out PDS and to evaluate the clinical results. We report 7 cases who underwent arthroscopic reduction and internal fixation using suture hook and pull-out PDS. All cases had fresh fractures generated within 3 weeks. The follow up period was at average 16.6 months. The fracture union was achieved at average 7.4 weeks. Knee exercise was started 2 weeks after the operation. One of the patients, who had combined injury of posterior cruciate ligament and lateral meniscus, showed limitation of knee movement. But he was underwent the arthroscopic fibrolysis at one year later, he returned to normal range of motion. Arthroscopic treatment of displaced tibial spine fracture using suture hook and pull-out PDS showed good results including rigid fixation and early mobilization. Therefore it is thought to be one of the effective operative techniques in treatment of the tibial spine fractures.

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