• Title/Summary/Keyword: 수술 부위 감염

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Percutaneous Lateral Release and Medial Reefing for Recurrent Patellar Dislocation (재발성 슬개골 탈구의 경피적 외측부 유리술 및 내측부 중첩술)

  • Choi, Chong-Hyuk;Oh, Kyung-Soo;Kim, Hyoung-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.33-38
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    • 2006
  • Purpose: This study seeks to address the results of percutaneous lateral release and medial reefing for patients with recurrent patellar dislocation. Materials and Methods: This paper focuses on 27 cases from 25 patients who had a surgical operation at our hospital in a span of eight years and six months from the time of December 1996 to May 2005. The subjects consist of 11 males and 14 females, and their average age was 22.2 years old. All the patients had their trauma history, and the average frequency of dislocation before surgery was 11.5 times. Results: The congruence angle before operation was 23.3 degree on the average, while the lateral patellofemoral angle was -5.7 degree on average. However, the congruence angle after surgery came to -2.4 degree, while the lateral patellofemoral angle recovered to the normal range of within 11.5 degrees. Four cases showed the recurrent dislocation, and two out of those four cases had -35, -12 degrees of their lateral patellofemoral angle respectively and 59, 14 degrees of their congruence angle respectively. Conclusion: Using percutaneous lateral release with medial reefing can be considered as an effective treatment for recurrent patellar dislocation

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Clinical Experience of Photodynamic Therapy in Five Patients with Advanced Lung Cancer (진행성 폐암에서 광역동 치료로 호전된 5례에 관한 임상적 경험)

  • Kim, Yang-Ki;Lee, Young-Mok;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.72-77
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    • 2004
  • Background : A tracheobronchial obstruction in lung cancer is associated with significant morbidity and mortality due to dyspnea, cough, hemoptysis, and recurrent respiratory infection. It is well known that one of standard treatments is photodynamic therapy (PDT) in tracheobronchial obstruction after radiotherapy, chemotherapy, and/or surgery. We reported here the role of PDT in airway obstruction in patients advanced lung cancer. Method : Pre-treatment protocol consisted of clinical, radiologic, and bronchoscopic examination, pulmonary function test, and assessment of Karnofsky performance status. A 2 mg/kg of porfimer sodium was injected intravenously, and then followed by cylindrical and/or interstitial irradiation with 630 nm of laser after 48 hours. The repeated bronchoscopy for debridement of necrotic tissue and re-illumination was performed after 48 hours. Result : Improved airway obstruction and selective tumor necrosis were achieved by photodynamic therapy in all cases. Dyspnea and performance status were improved in three cases. A purulent sputum, fever and hemoptysis were improved in one of five cases. After PDT, all patients showed temporarily aggravation of dyspnea, two of five showed febrile reaction for a few days and nobody presented photosensitivity reaction, hemoptysis and respiratory failure. Conclusion : Our experiences of PDT are effective in palliation of inoperable advanced lung cancer in terms of tracheobronchial obstruction.

Acute Aortic Injury after Nuss Bar Removal -A case report- (너스바 제거 후 발생한 급성 대동맥 손상 -치험 1예-)

  • Lee, Yang-Haeng;Park, Jae-Min;Han, Il-Yong;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.868-871
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    • 2006
  • Nuss operation as a method for correction of pectus excavatum is safe and satisfactory, but its complication presents pneumothorax, displaced bar, wound infection, pericarditis, pleural effusion, hemothorax, cardiac injury etc. We report a rare case of acute ascending aortic rupture after displaced and adhered Nuss bar removal. The patient was a 30-years old man who received Nuss operation 3 years ago. Nuss bar was removed without resistance but massively bled at both operation wound, so immediately femoro-femoral CPB and median sternotomy was done and repaired proximal aortic arch under deep hypothermic total circulatory arrest. The patient was discharged without complication at postoperative 13 day.

A Case of Infected Huge Lymphangioma in Pelvic Cavity (골반강에 발생한 감염된 거대 림프관종 1예)

  • Choi, Woo-Seok;Lee, Seong-Ho;Chung, Seok-Young;Song, Phil-Hyun;Baek, Un-Gi;Cho, Chul-Kyu;Park, Tong-Choon;Choi, Joon-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.63-67
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    • 2002
  • Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developes at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma ansing from pelvic cavity and involving bladder wall.

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A Surgical Idea for Wide Communicated Wound on Laryngopharynx (인후두의 개방적 외상에 대한 수술적 고찰)

  • 이종원;국태진;이정헌;염시경
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.7.4-8
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    • 1982
  • The common causes of neck closed injuries are automobile accidents and sports troubles; open injuries are gun-shot wounds and stab wounds. Generally, the treatment of wide laryngopharyngeal injuries consists of tracheostomy for adequate airway, simple repair and, later, surgical intervention for chronic laryngeal stenosis and hypopharyngeal reconstruction. Recently, authors experienced a case of extensive communicated wound with large defect on the layngopharyngeal structures and anterior neck skin. This large defect was reconstructed with horizontal cervical skin flap after total laryngectomy.

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Submental Intubation for Maxillofacial Surgery -A Case Report - (구강악안면수술을 위한 악하 기관 삽관 -증례보고-)

  • Kim, Soung-Min;Kwon, Kwang-Jun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.4 no.2 s.7
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    • pp.96-99
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    • 2004
  • 구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

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Charcot Spinal Arthropathy with Extensive Vertebral Body Destruction and Cerebrospinal Fluid Collection: A Case Report Mimicking Infective Spondylitis (척추체의 광범위한 파괴와 뇌척수액 축적이 동반된 샤르코 척추 관절병증: 감염성 척추염과 유사한 소견을 보이는 증례보고)

  • Cho, Kyu-Jung;Kim, Yeo-Ju;Kim, Young-Tae;Youn, Yung-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.348-353
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    • 2020
  • A 68-year-old man presented with a bed sore with pus discharge on lower back. Radiographs showed extensive destruction of the L4 vertebral body. Magnetic resonance imaging (MRI) showed fluid collection with an enhanced wall at the defect of the L4 vertebral body extending into both psoas muscles. The primary diagnosis was neuropathic spondylopathy, but infective spondylitis was not ruled out. Initially, he was treated with antibiotics for two weeks. A follow-up MRI showed no improvement of the abscess, so surgical exploration was done. Charcot spinal arthropathy resulted in extensive vertebral body destruction that may be similar to infectious spondylitis, particularly in the case with fluid accumulation due to rupture of dura.

Infective Endocarditis Involving Aortic Valve, Mitral Valve, Tricuspid Valve, and luterventricular Septum -A Case Report (대동맥판막, 승모판막, 삼첨판막과 심실중격을 침범한 심내막염 -1예 보고-)

  • 박종빈;서동만
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.200-204
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    • 1997
  • This is a report of a successful management of a patient with infective endocarditis involving native aortic valve, mitral valve, tricuspid valve, and Interventric lar septum. A 16 year-old patient who underwent VSD patch closure, and aortic valvuloplasty at the age of 1 1 years showed Intractable congestive heart failure during antibiotics treatment for infective endocarditis. Operative findings revealed that there were large defect along the previous patch, aortic regurgitation with multiple perforations and vegetations, mitral regurgitation with vegetation, aortic paraannular abscess, interventricular myocardial abscess, and tricuspid regurgitation with perforations and vegetations. We reconstructed the interventricular defect with Dacron patch extending to the aortic valve annulus after radical debridement of all infected or devitalized tissues, and could implant aortic valve by anchoring to the reconstructed Dacron patch. Mitral valve was replaced and tricuspid valve was repaired with patient's own pericardium. The patient was discharged after antibiotics treatment for 6 weeks and in good condition without any sequelae for 12 months.

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Surgical Treatment of Tracheal Stenosis (기관 협착증의 외과적 치료)

  • 최준영;장인석;김종우;김병균;이정은;김성호;이상호
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.565-569
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    • 2000
  • Background; Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. Material and Method; From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. Result; There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. Conclusion; Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.

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상부기도 협착의 나선식 CT를 이용한 3차원 영상의 진단적 의의

  • 김승현;김현웅;노영수;임현준;윤대영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1997.04a
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    • pp.119-119
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    • 1997
  • 상부기도 협착의 원인은 장기간의 기관 삽관, 외상, 감염, 종양, 및 선천적인 결함등에 의해 존재하며, 이에 대한 진단은 단순 촬영이나 전산화 단층 촬영술 등으로 쉽게 진단은 가능하나, 적절한 치료 계획을 세우기 위해서는 그 범위 및 정도를 정확히 파악하는 일이 중요하다 최근 방사선 촬영기술의 발달로 현재의 2차원적 단면 영상에서 3차원적 영상으로 발전해왔으며 상부기도 협착 또한 3차원적 영상으로 진단하려는 노력이 시도되고 있다. 이에 저자들은 최근에 경험한 기관 협착증 7례에서 3D CT를 시행하여 협착 부위의 상태를 기존의 단순 촬영 영상 및 2D CT 영상과 비교하였고, 7례의 기관 협착증 중 4례에서 기관 단단 문합술 및 후두 기관 문합술을 시행한 바 수술시 확인된 협착 상태를 3D CT 영상과 비교하였다.

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