• Title/Summary/Keyword: 완전 절제술

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Surgical Treatment of Myasthenia Gravis (중증 근무력증의 수술적 치료)

  • 강정수;김길동
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1010-1016
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    • 1996
  • Thymectomy is an accepted therapeutic modality for patients with myasthenia gravis. The selection of patients for operation, the timing of operation and the surgical approach are still controversial. We reviewed 82 patientsraged 13 to 66 years; mean age, 37.7 years treated with transsternal thymectomy between January 1983 and December 1994. Patients were symptomatically staged according to the modified Osserman's classification. There was one hospital death and postoperative follow-up was obtained on 75 patients. During a mean follow up of 56.9 months, 64 patients (85.3%) benefited from the operation with complete remis ion achieved in 28(37.3%). The thyroid disease was present in 8 patients, of whom 7(87. 5%) achieved complete remission in contrast to 21 (31.3%) of the 67 patients without thyroid disease. The disease duration less than 2 years in 32 patients was associated with complete remission in 16 (50%) in contrast to remission in 12(27.4%) of the 43 patients whose disease duration was more than 2 years. In conclusion, the complete remission rate after transsternal thymectomy was affected by the presence of thyroid disease and disease duration. Myasthenia gravis with late onset(>40 years), thymoma pathology, old age and male gender appear to decrease the complete remission rate after transsternal thymectomy, although it was not statistically significant. There was no difference of complete'remission rate between normal and hyperplasia of thymus. Transsternal thymectomy was found to be beneficial in most patients with myasthenia gravis, but the majority of patients with ocular disease did not b nefit from the operation.

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Prospective Comparative Study of Arthroscopic Repair Versus Debridement for the Full-Thickness Tear of Upper Subscapularis (상부 견갑하 건 완전파열의 관절경 하 봉합술과 변연절제술의 전향적 비교)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Lee, Chae-Chil;Park, Han-Chang;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.79-85
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    • 2010
  • Purpose: To evaluate the results from arthroscopic repair versus debridement for full-thickness tears of the upper subscapularis tendon. Materials and Methods: Ninety-nine patient outcomes were evaluated and compared prospectively. Sixty-nine patients with full-thickness tears of the upper subscapularis tendon underwent arthroscopic repair (group I) and thirty patients underwent simple debridement (group II) between May 2003 and October 2007. In all patients, the tear was localized to the superior one third of the upper subscapularis tendon. The results of the treatment were assessed by evaluating the UCLA, ASES, and VAS for pain and internal rotation strength scores before and after the operation. Results: In groups I and II, UCLA, ASES, VAS, and internal rotation muscle power (perfect score = 5) scores were improved after surgery. In comparing group I and group II, the UCLA and VAS scores were not significantly different (p>0.05), while the ASES and internal rotation strength scores were significantly different (p<0.05). Conclusion: The arthroscopic repair of full-thickness tears of the upper subscapularis tendon was a better surgical method than simple debridement.

Surgical Treatment of Complete Atrioventricular Septal Defect with Tetralogy of Fallot - Report of one case - (활로씨 4징증을 동반한 완전방실중격결손의 수술치험 -1례 보고-)

  • 이재훈;이광숙;박남희;최세영;박창권;유영선
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.460-462
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    • 2002
  • We experienced primary repair of complete atrioventricular septal defect with Teralogy of Fallot. The diagnosis was established preoperatively by echocardiography, cardiac catheterization and cardioangiography. Repair was accomplished using cardiopulmonary bypass. Two patch techinque were performed using Dacron patch for ventricular septal defect and pericardial patch for atrial septal defect. Infundibullectomy and right ventricular outflow tract reconstruction with the transannular pericardial patch were performed. The postoperative echocardiography showed mild mitral and tricuspid regurgitation, but there were no hemodynamic abnormalities.

Psychosocial Experience in Post-mastectomy Women (유방완전절제술을 받은 여성의 심리사회적 경험 : 자조집단 참여자 중심으로)

  • Lee, Yoon-Soo
    • Korean Journal of Social Welfare
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    • v.59 no.3
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    • pp.99-124
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    • 2007
  • The purpose of this study is to research psychosocial experience in post-mastectomy women, who participated in self-help group, using in-depth interviews and participant observations. Until recently, studies on post-mastectomy women in psychological perspectives had been maily done by nurses, and there are only few literatures in social welfare studies. Therefore, based on phenomenological theory, the meaning and essence of "the breast" and the lived experience of post-mastectomy women, i.e. emotional distress, and as a result has been explored, it has confirmed six clusters and explained them in detail. As a result, from the subjects' experience, the essence of 'A crossroad of life and death', 'sexual-identity crisis', 'feeling mortified due to double binded messages of others', 'conflict between physical and psychological disabilities', 'feelings of gratitude or wishfulness', and 'their realistic suggestions and wishes' has been shown. It has been founded that the subjects experienced not only self-identity crisis as women but also unending internal turmoil because of their passion to live. It has been hoped that this study will help to shape government policy and social welfare services on post-mastectomy patients.

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Surgical Results for Myasthenia Gravis (중증근무력증의 수술적 치료 결과)

  • 장인석;김성호
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.72-76
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    • 1997
  • Myasthenia gravis is relatively rare disease which is related autoimmune response. There are various methods of management for myasthenia gravis, but nowaday radical thymectomy is the treatment of choice in the aspect of bringing out complete remission and clinical improvement. Sixteen patients of myasthenia gratis underwent radical thymectomy during last eight years, and its result was analysed. Complete rem ssion was achieved in five patients (31 %) and pharmacological or symptomatic improvement in seven patients (44%), thus giving a total remission in 12 patients (75%). Postoperative result was not correlated with age, sex, degree of preoperative symptom, surgical approach, pathologic diagnosis.

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Prosthetic rehabilitation for a glossectomy patient - a clinical report (혀절제술을 시행한 환자의 보철적 수복 증례)

  • Yoon, Jiyoung;Lee, Siho;Lee, Jiyoen;Oh, Namsik
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.347-352
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    • 2013
  • Malignant tumours of the oral cavity that require resection of the tongue result in severe deficiencies in speech and deglutition. In such patients, improvements in mastication, swallowing, and speech may be reasonable goals for treatment. The viability of a prosthodontic approach to treatment depends on the type and extent of surgery. In a total glossectomy, a mandibular tongue prosthesis is the treatment of choice. Mandibular tongue prosthesis occupies the space in the floor of the oral cavity. It provides the patients with a platform for directing food into the esophagus and aids in speaking. This type of prosthesis can achieve that protection of the underlying fragile tissue and improvement in appearance and psychosocial adjustment. This case report describes the technical steps involved in prosthetic rehabilitation for a glossectomy patient.

Clinical esxperiences of Carotid Endarterectomy for Carotid Stenosis (경동맥 내막 절제술을 이용한 경동맥 협착증 치료에 대한 임상적 고찰)

  • 최인석;박주철;정경천;장대일
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1087-1092
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    • 1999
  • 배경 :경동맥 내막 절제술의 목적은 뇌졸중 예방에 있다. 경동맥 내막 절제술시 경동맥 혈류를 차단하였을 때 뇌허혈 상태를 초래하는지 가 가장 중요한 문제이다. 경동맥 혈류 역류압은 뇌내 측부혈류 상태를 반영하므로 경동맥 혈류 차단시 역류압과 뇌파검사 소견에 딸라 shunt 삽입여부 기준을 알아보려고 하였다 대상 및 방법 : 1996년 2월부터 1999년 3월까지 경동맥 내막 절제술을 시행받은 16명을 대상으로 하였다 남자가 14명있고 여자가 2명이었으며 평균연령은 66.35$\pm$6.53이었다 수술부위 경동맥 협착은 평균 73.8$\pm$12.33%였고 반대측 경동맥 협착은 평균 60.99$\pm$23.03%였다. 수술중 모든 환자에서 뇌파감시를 하였으며 경동맥 혈류압을 측정하여 40 mmHg 이하이거나 수술반대측 경동맥 완전폐색이 있는 경우 shunt를 삽입하였다 결과 : 술후 1례에서 사망이 있었는데 이 환자는 전, 중 뇌내동맥 영역에 큰 뇌경색이 있으며 동측에 심한 경동맥 협착이 있고 의식은 기면 상태여서 바로 응급수술을 하였다 수술시경동맥 혈류 역류압은 35mmHg 여서 shunt를 사용하였다 술후 1일째 의식이 혼수상태로 나빠져 뇌 단층촬영한 결과 뇌경색 부위에 출혈이 발생하여 사망하였다. 수술 직후 모든 환자에서 뇌허혈에 따른 합병증 및 사망은 없었고 1례에서 수술후 1일째 수술부위 반대편에 적은 뇌경색이 발생하였다 평균 21.5$\pm$11.85개우러의 외래 추적 검사에서 뇌졸중 재발이 없었다. 결론 : 뇌졸중이환후 경동맥 내막 절제술은 최소 4-6주 이상 안정화 시킨 다음 수술하는 것이 좋다고 생각된다 경동맥 내막 절제술은 뇌졸중 예방에 효과적인 치료방법이며 경동맥 혈류역류압이 40mmHg 이하일 경우 shunt를 설치하여 수술하는 것이 안전하다고 사료된다.

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SURGICAL EXCISION OF MUCOUS RETENTION PHENOMENON (점액낭종의 외과적 처치)

  • Kim, Jae-Gon;Kim, Young-Jin;Kim, Mi-Ra;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.216-221
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    • 2000
  • Mucoceles and Ranulas are mucous retention phenomena, ie, they develop from the extravasation or retention of mucous after trauma to the sublingual gland or one of the minor salivary glands. Mucoceles are chronic in nature, and local surgical excision is necessary. To minimize the chance for recurrence, the underlying feeder glands should be removed in continuity with the mucocele. Ranula is a term used for mucoceles that occur in the floor of the mouth Treatment consists of marsupialization and/or removal of the feeding sublingual gland. Marsupialization entails removal of the roof of the intraoral lesion. However this procedure is often unsuccessful. Some prefer initially to excise the entire sublingual gland. This case report presents two cases. one case was developed on lower lip and treated by marsupialization. There was no recurrence during follow up period.

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Complete denture rehabilitation of partially glossectomized patient using palatal augmentation prosthesis: A case report (부분 혀 절제술을 받은 완전 무치악 환자에서 구개증대보철물을 이용한 수복 증례)

  • Hyeon-Kyeong Lee;Na-Hong Kim;Hee-Won Jang;Sun-Young Yim;Keun-Woo Lee;Sung-Yong Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.82-89
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    • 2023
  • The tongue is one of the most common sites of oral cancer. Glossectomy is known as the gold standard for tongue cancer treatment. However, surgical removal can lead to reduced mobility of the tongue and the patients may have difficulty performing normal oral functions like swallowing and pronunciation. Therefore, additional prosthetic consideration to supplement the function of the impaired tongue is needed for oral rehabilitation of such patients. Palatal augmentation prosthesis helps the tongue to reach the palate by lowering the position of the palatal polished surface. The oral functions of the patients with limited tongue mobility can be improved by the prosthesis. In this case, palatal augmented maxillary denture and conventional mandibular denture were fabricated for the completely edentulous patient with reduced tongue mobility after glossectomy due to tongue cancer. As a result, the oral functions of the patient were improved with the prosthesis.