• Title/Summary/Keyword: 수술 후

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Meningeal Hemangiopericytoma Treated with Surgery and Radiation Therapy - Case Report - (수막 혈관주위세포종 환자에서의 수술과 방사선치료 -증례보고-)

  • Jang Ji-Young;Oh Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.149-155
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    • 2006
  • Meningeal hemangiopericytoma (HPC) is an uncommon dura-based tumor and can recur not only locally but also distantly in the neural axis or extraneural sites. We report our experience of radiation therapy, one preoperative and one elective postoperative, In two patients with meningeal HPC and reviewed the role of radiation therapy. A 41-year-old man (Case 1) presented with a 3-month history of headache and right hemiparesis. The mass was nearly unresectable at the first and second operation and diagnosed as meningeal HPC. Preoperative radiation therapy was given with a total dose of 55.8 Gy/31 fractions to the large residual mass of left frontoparietal area. Follow-up computerized tomography (CT) showed marked regression of tumor after radiation therapy. The third operation was peformed to remove the residual tumor at 6 months after the radiation therapy and a $2{\times}2cm$ sized tumor was encountered. The mass was totally removed. The serial follow-up CT showed no evidence of recurrence and he is alive without distant metastasis for 4 years and 10 months after the first operation. A 45-year-old woman (Case 2) presented with suddenly developed headache and visual impairment. Tumor mass occupying right frontal lobe was removed with the preoperative diagnosis of meningioma. It was totally removed with attached sagittal sinus and diagnosed as meningeal HPC. Elective postoperative radiation therapy was peformed to reduce local recurrence with a total dose of 54 Gy/30 fractions to the involved area of right frontal lobe. She is alive for 5 years maintaining normal activity without local recurrence and distant metastasis.

Evaluation of Surgical Outcome with Pre-and Post-operative Rest/Acetazolamide Tc-99m HMPAO SPECT in Children with Moyamoya Disease (어린이 모야모야병에서 휴식/아세타졸아미드 Tc-99m-HMPAO SPECT를 이용한 수술결과 평가)

  • Lee, D.S.;Hyun, I.Y.;Wang, K.C.;Cho, B.K.;Chung, J.K.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.314-324
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    • 1998
  • Purpose: This study was performed to evaluate the outcome of encephalo-duro-arterio-synangiosis (EDAS) surgery with rest/acetazolamide Tc-99m HMPAO SPECT in moyamoya disease. Materials and Methods: Rost/acetazolamide subtraction SPECT with consecutive acquisition were done before and 2 months after 21 EDAS surgeries in 18 patients. Perfusion decrease was graded visually for 14 areas of each hemisphere as 0 (normal) to 3 (defect) using 4 point scoring system. Postoperative rest perfusion or perfusion reserve was compared with preoperative ones. Results: Among 294 areas of 21 hemispheres, rest perfusion abnormality was found in 91 areas of 15 hemispheres. Decrease of perfusion reserve was found in 146 areas of 18 hemispheres. Six hemispheres having normal rest perfusion and 12 of 15 hemispheres having rest perfusion abnormality showed reserve decrease. Three having rest perfusion defect did not change after acetazolamide in preoperative SPECT. After operation, 16 patients (89%) demonstrated clinical improvement. Fifteen among 18 hemispheres (83%) with decreased reserve improved. Rest perfusion abnormality improved in 6 among the 15 hemispheres (40%). The areas having rest perfusion and/or reserve decrease improved in 87 among 146 areas (60%). Decrease of reserve, improved in 85% (68/80). However, areas without reserve decrease also improved in 29% (19/66). The better was preoperative rest perfusion in involved areas or the more decreased vascular reserve, the more improved perfusion and reserve after operation. Conclusion: We conclude that assessment of perfusion and Perfusion reserve using rest/acetazolamide brain perfusion SPECT predict the surgical outcome in patients with moyamoya disease.

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The Role of Adjuvant Postoperative External Beam Radiotherapy for Locoregional Control in Recurrent Advanced Papillary Thyroid Carcinoma : Preliminary Report in a Single Institute (재발된 진행 갑상선 유두암의 국소 및 부위 치료를 위한 수술후 보조 외부방사선의 역할)

  • Park, Sung Ho;Lee, Guk Haeng;Lee, Byeong Cheol;Lee, Myung Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.29-35
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    • 2015
  • 목적 : 국소 재발한 진행된 갑상선 유두암의 치료로 수술 후 외부방사선의 역할을 알아보고자 하였다. 대상 및 방법 : 원자력병원에서 2000년 1월부터 2012년 2월까지 사이버나이프 혹은 외부방사선 치료를 받은 수술과 방사선요오드 치료 후 국소 재발한 진행된 갑상선 유두암 환자 13 명을 대상으로 하였다. 경과관찰 기간 동안 국소 및 부위 재발이 발생환 환자는 6 명이었다. 몇몇의 위험인자를 찾기 위해서 Kaplan-Meier method와 log-rank test를 이용하여 성별, 종양단계, 방사선 치료 전 수술 횟수, 방사선요오드치료 횟수, 수술 후 잔존 암의 여부, 원격전이에 대해 단변량 분석하였다. 결과 : 방사선 치료 후 평균 추적관찰기관은 53.8개월(범위, 36 ~ 108개월)이고 그중 남자는 4 명이었다. 1년, 2년의 무진행 생존률은 각각 76.9와 53.8%였다. 단병량 분석은 성별과 잔존 암여부(p = 0.0475 and p = 0.0475, 각각)에 따라 무진행 생존률이 진행한 그룹과 진행하지 않은 그룹 사이에 유의한 차이가 있다는 것을 보여줬다. 결론 : 외부 방사선 치료 전에 잔존 암이 없었던 환자의 100%에서 국소 및 부위 재발이 일어나지 않았다. 외부방사선 치료는 수술과 방사선요오드 치료에 반응하지 않는 환자 중 수술 후 잔존 암이 없는 경우에 효과적인 치료 방법이 될 수 있다.

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Spermatogenesis and Fertility Following Orchiopexy and GnRH Treatment in an English Bulldog after Puberty with Bilateral Cryptorchidism (양측성 잠복고환견에서 성성숙 후 고환하강고정술과 GnRH 투여를 통한 생식능력 회복례)

  • Oh, Hong-Geun;Kim, Sue-Hee;Park, Jong-Seong;Kim, Yong-Jun
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.647-649
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    • 2009
  • An orchiopexy was performed in an 18-month old adult English bulldog with bilateral cryptorchidism. One month postoperatively, the dog was twice-treated with GnRH (50 ug/kg) at an interval of 2 weeks. Semen was collected and evaluated before and after surgery. Fertility was determined by artificial insemination. No spermatozoa were observed before orchiopexy and 2 months postoperatively. However, 6 live sperm were detected 4 months postoperatively and normal sperm characteristics (except sperm concentration) were present 7 months postoperatively. A female bulldog, inseminated with the semen from the bulldog 8 months postoperatively, delivered 6 offsprings. Spermatogenesis and spermatozoa with fertilizing capacity were recovered by postpubertal orchiopexy and GnRH therapy in a bilateral cryptorchid dog.

Thoracoscopic Esophagectomy for Esophageal Cancer -One Case Report- (식도암에서의 흉강경 식도적출술 치험 1례)

  • Jeong, Jin-Yong;Yeon, Seong-Mo;Park, Kuhn;Kwack, Moon-Sub;Kwak, Seung-Soo
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.418-421
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    • 1998
  • Thoracoscopic esophagectomy can be performed in esophageal diseases to reduce the postoperative complications. Recently, We encountered a case of esophageal cancer and successfully treated it by thoracoscopic esophagectomy with gastric pull-up. A 59-year-old male was presented with swallowing difficulty and an esophagogram, esophagoscopy, and chest CT showed an ulcerating tumor on the lower esophagus. The operation was performed in three stages: mobilization of the esophagus by thoracoscopic surgery, construction of a gastric tube through a laparotomy, and cervical anastomosis between the esophagus and the gastric pull-through. Hoarseness developed postoperatively, and the postoperative esophagogram showed leakage at the esophagogastric anastomotic site. The anastomotic leakage was healed following surgical drainage and the patient was discharged in good health. Hoarseness subsided spontaneously two months after surgery.

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Various Regimens for the Functional Recovery after Arthroscopic Shoulder Surgery (견관절 관절경 수술 후 기능 회복 치료법)

  • Oh, Joo Han;Yoon, Ji Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.103-116
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    • 2020
  • The incidence of rotator cuff tear is increasing rapidly due to the aging of the population and the advancement of radiological diagnosis, and so on. Recently, arthroscopic rotator cuff repair is common way of surgery, and the surgical outcome is comparable to open rotator cuff repair. Arthroscopic repair is one of the minimally invasive procedures itself and may have additional benefits of postoperative pain reduction and early functional recovery. Recently, there has been increasing interest in various methods for improving the functional recovery of patients after arthroscopic shoulder surgery. Various protocols of functional recovery after arthroscopic shoulder surgery are classified by the postoperative period, and they are being studied actively and improved at each stage. On the other hand, there are a range of methods according to the postoperative period, rehabilitation stage, characteristics of individual patients, degree of rotator cuff tear, and underlying disease. Therefore, for functional recovery after arthroscopic rotator cuff repair, it is essential to establish proper regimens for functional recovery.

Postoperative Imaging of Rotator Cuff Tear (회전근개 파열의 수술 후 영상)

  • Min Hee Lee;Hee Jin Park;Ji Na Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1388-1401
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    • 2021
  • Postoperative imaging of the rotator cuff may be performed routinely, even if pain or disability develops after surgery or if there are no symptoms. Postoperative images are obtained through MRI or US, and the purpose is to confirm the integrity of the restored tendon in general. Postoperative MRI has a relatively poor diagnostic accuracy compared to that of preoperative images because various materials used in surgeries deteriorate the image quality. US can dynamically check the condition of the restored tendon and avoid artifacts from the surgical instruments used for recovery. Although imaging findings are not always consistent with the clinical symptoms or prognosis, sub-deltoid fluid retention is more important for pain and functional recovery than the thickness of the reconstructed tendon. Strain elastography can also be a useful method for predicting the prognosis.

계측 및 제어 기술을 이용하는 최소절개수술에 관한 연구 동향

  • Jo, So-Hyeong
    • Journal of the KSME
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    • v.54 no.3
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    • pp.42-46
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    • 2014
  • 전통적인 개복수술에 비해서 경감된 수술 후 회복기간 등 여러 가지 장점이 있는 최소절개수술은 수술자들에게는 훨씬 복잡하고 배우기 어려운 기법으로 알려져 있다. 이 글은 최소절개수술의 기법을 향상시키는 데 도움이 되는 다양한 계측 및 제어 기술을 검토하고 새로운 디바이스를 소개하는 데 초점을 둔다.

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A study on the perimandibular tissues before and after orthodontic treatment with orthognathic surgery in mandandibular prognathic patients (하악골 전돌자의 악교정 수술을 동반한 교정치료 전후 하악골 주위조직의 변화에 관한 연구)

  • Yang, Byung-Ho;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.261-272
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    • 2000
  • Severe skeletal anteroposterior and vertical discrepancy is difficult to obtain satisfactory result by only orthodontic treatment, and much anteroposterior movement and treatment stability require orthodontic treatment with orthognathic surgery. The treatment goal of mandibular prognathic patients is to promote the function of stomatognathic system including mastication and phonetics, to improve the esthetics of facial profile and to maintain stability. Positional changes of hyoid bone, pharynx and tongue were seen with mandibular movement after orthognathic surgery. This study was performed to observe the changes of perimandibular tissues of orthodontic patients with skeletal mandibular prognathism who treated with orthodontic treatment, and the changes of hyoid bone, pharyx and tongue by relapse or recurrance after before and after orthognathic surgery and retention. The 22 patients who had mandibular prognathism were selected. They treated with orthodontic treatment with sagittal split ramus osteotomy as orthognathic surgery. And lateral cephalometric radiographs were taken 3 times : pre-surgery (T1), immediate post-surgery (T2) and 2 years alter retention (T3). The results were as follows : 1. The hyoid bone returned back after clockwise rotation to maxilla and occlusal plane during retention (P<0.01). 2. The hyoid bone moved posterior-inferiorly by mandibular surgery and returned back anterior-superior after retention. (P<0.01) 3. The changes of pharyngeal depth showed a little decrease at upper area in post- surgery, but it was not a significant difference generally through before, after and retention. 4. In relating to tongue base, the angle of tongue base was decreased and the dorsal area of tongue base moved to inferior-posterior direction and to superior direction again after retention (P<0.01). 5. Related to the thickness of upper and lower lip, the thickness of upper lip decreased after surgery, and the soft tissues below lower lip increased after surgery and decreased after retention.

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Mediastinoscopic Lumbar Sympathectomy (종경동경을 이용한 요부 교감신경 절제술)

  • Kim Dong Won
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.229-232
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    • 2005
  • Lumbar Sympathectomy is a surgery for plantar hyperhidrosis, vascular and other reflex sympathetic diseases and has a various indications and physiologic effects. However it is not performed actively compared to thoracic sympathectomy because of its invasiveness. Therefore, we tried to perform lumbar sympathectomy using mediastinoscopy with small incision and introduce this new surgical technique. Material and Method: From July 2003 to December 2004, 18 patients undewent lumbar sympathectomy with mediastinoscopy at Inje University Sanggye Paik Hospital. There were 12 males and 6 females whose mean age was 24.3$\pm$8.2 years ranging from 18 to 67 30 cases of lumbar sympathectomy was performed with mediastinoscopy of which 24 cases were for plantar hyperhidrosis and 6 cases for other diseases. Result: Mean operation time was 37.2$\pm$12.5 minutes and mean post operation hospital stay was 3.1$\pm$2.2 days. There was one post sympathetic neuralgia and one peritoneal opening. Conclusion: Lumbar sympathectomy using mediastinoscopy is a simple and effective technique and has the advantage of cosmetics, post operative pain and hospital stay. However, further studies with large number of cases should be carried out for better outcome.