• Title/Summary/Keyword: 외과적 적출술

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Benign Mediastinal Cystic Teratoma Complicated by Cardiac Tamponade due to Trauma (외상에 의하여 심장눌림증을 유발한 종격동 양성낭기형종)

  • Choe Ju-Won;Kim Yong-In
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.729-732
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    • 2006
  • Mediastinal teratoma is one of the most common lesions found in the anterior mediastinum, accounting for $8\sim13%$ of all mediastinal tumors. This tumor is incidentally detected by routine chest roentgengography, but pericardial perforation or pleural effusion occurs rarely. In our patient cardiac tamponade was developed due to anterior chest wall contusion, we confirmed the anterior mediastinal tumor. Vital signs were stabilized after the pericardiocentesis, and the patient underwent the tumor resection in the anterior mediastinum for a definite treatment. On histologic examination, the tumor revealed cystic structures composed of mature squamous epithelium, pilosebaceous glands, mature fat tissue, gastrointestinal mucosa, respiratory epithelium, and pancreatic tissues.

TREATMENT OF RADICULAR CYST USING DECOMPRESSION (감압술을 이용한 치근단 낭의 처치)

  • Kim, Nam-Hyuk;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu;Kim, Seong-Oh;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.275-280
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    • 2009
  • Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

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Intra-abdominal Retained Surgical Gauze in Two Dogs (개의 복강내 잔존 수술용 거즈 2예)

  • Choi, Ho-Jung;Lee, Ki-Ja;O, I-Se;Lee, Jae-Yeon;Jee, Hyun-Chul;Park, Seong-Jun;Jeong, Seong-Mok;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.238-243
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    • 2007
  • This report describes the retained surgical gauze in two dogs that had ovariohysterectomy previously. The elapsed time between surgery and diagnosis of retained surgical gauze in two dogs was 30 and 16 months, respectively. Radiographic signs included localized abdominal mass (case 1, 2) and soft tissue swelling (case 2). Retained surgical gauze was imaged by survey radiography, ultrasonography and computed tomography (CT). Ultrasonography revealed a hypoechoic mass with irregular hyperechoic center in case 1, and hypoechoic mass with oval hyperechoic center and acoustic shadowing in case 2. In CT examination of case 2, hyperdense mass with a thick peripheral rim enhancing in contrast study was shown. Cytologic examination of both cases revealed abscess and granuloma respectively. The lesions were surgically removed. The possibility of retained surgical gauze should be considered in animals with a history of previous surgery with abnormal mass.

THE EVALUATION OF THE PATIENTS TAKING CBCT IN DEPARTMENT OF PEDIATRIC DENTISTRY (소아치과에서 Cone beam형 전산화단층영상을 이용한 환자의 평가)

  • Jeon, Hye-Jin;Yang, Yeon-Mi;Kim, Jae-Gon;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.3
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    • pp.249-256
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    • 2012
  • Cone beam computed tomography (CBCT) has become widely available in recent years and is recognized as an important diagnostic tool for varies disease and condition of the orofacial structure. Clinician is easy to determine adequate treatment plan for pediatric patients by using CBCT. CBCT is used in Chonbuk National University Dental Hospital since 2005. This research presents clinical application of CBCT on patients visiting department of pediatric dentistry in Chonbuk National University Dental Hospital from Jan, 2005 to July, 2011. 1. Total number of patients taken CBCT is 252, and total number of area taken CBCT is 279. 2. An age group form 9 years to 12 years showing 53% was highest and percentage of 6~8 years showed 24%. 3. Chief complaints for CBCT taking are position and shape of impacted teeth (49.1%), mesiodens (19.4%), supernumerary teeth (7.9%), position and root canal shape of erupting teeth (7.2%), cyst (5.4%), inflammatory lesion (3.9%), odontoma (3.9%), tumor (2.2%), and et al. 4. Treatments are extraction (29.7%), orthodontic traction and leveling (24.0%), follow up (16.5%), refer to other professional part (11.5%), endodontic treatment (3.9%), surgical removal (2.9%), malsupialization (3.9%), enucleation (1.1%), and fail to follow up (5.0%), and et al.

A CASE REPORT OF THE HUGE CEMENTO-OSSIFYING FIBROMA OF THE MANDIBLE (하악골에 발생한 거대한 cemento-ossifying fibroma의 치험례)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Kwon, Yong-Dae;Park, Jong-Oh
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.70-75
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    • 2000
  • The cemento-ossifying fibroma is a well-demarcated and occasionally encapsulated neoplasm composed of fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. The greatest number of cases are encountered during the third and fourth decades of life and there is a definite female predilection, with female-to-male ratios as high as 5 : 1 being reported. The mandible is involved far more than the maxilla, and 90 percent of all cases are located in the mandible. The mandibular premolar-molar area is the most common site. Radiographically, the lesion is most often well defined and unilocular. Depending on the amount of calcified produced in the tumor, it may appear as completely radiolucent ; more often it shows varying degrees of radiopacity. Some lesions may be largely radiopaque with a radiolucent halo. On microscopic study, the tumor is composed of fibrous tissue of varying degrees of cellularity containing calcified material. This may be in the form of trabeculae of osteoid and bone or basophilic ovoid calcifications that resemble cementum-like material. Admixture of the two types of calcifications are commonly seen. On this case, large cemento-ossifying fibroma has grown in the mandible and this lesion was treated by complete surgical excision and posterior iliac bone graft. A review of literature and a report of a case of cemento-ossifying fibroma are presented.

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Surgical Treatment of Renal Cell Carcinoma with IVC Tumor Extension Using Deep Hypothermic Circulatory Arrest - A Case Report - (심도 저체온 순환 정지를 이용한 하대정맥에 파급된 신세포암의 수술적 치료 -1례 보고-)

  • Kang, Shin-Kwang;Kim, Si-Wook;Won, Tae-Hee;Ku, Kwan-Woo;Na, Myung-Hoon;Yu, Jae-Hyun;Lim, Seung-Pyung;Lee, Young;Sul, Jong-Goo
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.755-759
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    • 2002
  • A 64-year-old man was admitted for gross hematuria. Preoperative study revealed right renal cell carcinoma with inferior vena cava(IVC) tumor thrombus. Right radical nephrectomy was performed, and deep hypothermic circulatory arrest(DHCA) with retrograde cerebral perfusion(RCP) was used for extraction of tumor thrombus in the IVC. The thrombus originated from the right kidney, which extended the orifice of the gonadal vein in the left renal vein laterally, the hepatic vein superiorly, and 3cm below the right renal vein inferiorly. The thrombus was removed completely without caval wall injury under DHCA with RCP, and the postoperative course was uneventful. He received immunotherapy with interferon, and followed up without any surgical problem.

Is Video-assisted Thoracoscopic Resection for Treating Apical Neurogenic Tumors Always Safe? (흉강 첨부 양성 신경종의 흉강경을 이용한 절제술: 언제나 안전하게 시행할 수 있나?)

  • Cho, Deog Gon;Jo, Min Seop;Kang, Chul Ung;Cho, Kyu Do;Choi, Si Young;Park, Jae Kil;Jo, Keon Hyeon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.72-78
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    • 2009
  • Background: Mediastinal neurogenic tumors are generally benign lesions and they are ideal candidates for performing resection via video-assisted thoracoscopic surgery (VATS). However, benign neurogenic tumors at the thoracic apex present technical problems for the surgeon because of the limited exposure of the neurovascular structures, and the optimal way to surgically access these tumors is still a matter of debate. This study aims to clarify the feasibility and safety of the VATS approach for performing surgical resection of benign apical neurogenic tumors (ANT). Material and Method: From January 1996 to September 2008, 31 patients with benign ANT (15 males/16 females, mean age: 45 years, range: 8~73), were operated on by various surgical methods: 14 VATS, 10 lateral thoracotomies, 6 cervical or cervicothoracic incisions and 1 median sternotomy. 3 patients had associated von Recklinhausen's disease. The perioperative variables and complications were retrospectively reviewed according to the surgical approaches, and the surgical results of VATS were compared with those of the other invasive surgeries. Result: In the VATS group, the histologic diagnosis was schwannoma in 9 cases, neurofibroma in 4 cases and ganglioneuroma in 1 case, and the median tumor size was 4.3 cm (range: 1.2~7.0 cm). The operation time, amount of chest tube drainage and the postoperative stay in the VATS group were significantly less than that in the other invasive surgical group (p<0.05). No conversion thoracotomy was required. There were 2 cases of Hornor's syndrome and 2 brachial plexus neuropathies in the VATS group; there was 1 case of Honor's syndrome, 1 brachial plexus neuropathy, 1 vocal cord palsy and 2 non-neurologic complications in the invasive surgical group, and all the complications developed postoperatively. The operative method was an independent predictor for postoperative neuropathies in the VATS group (that is, non-enucleation of the tumor) (p=0.029). Conclusion: The VATS approach for treating benign ANT is a less invasive, safe and feasible method. Enucleation of the tumor during the VATS procedure may be an important technique to decrease the postoperative neurological complications.

Recurrent ossifying and cemento-ossifying fibroma of the jaws;report of 2 cases (재발된 골섬유종과 백악질골섬유종)

  • Ryu, Sun-Youl;Oh, Hee-Kyun;Kim, Geon-Jung;Yun, Young-Su;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.297-308
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    • 1989
  • These are two case reports of recurrent ossifying and cemento-ossifying fibroma in a year or 5 months following conservative treatment. Ossifying fibroma or cemento-ossifying is a relatively uncommon benign fibro-osseous tumor of the jaws, and is generally believed to originate from periodontal ligaments. In recent, it is not demanded more differentiation of ossifying, cementifying and cemento-ossifying fibroma due to the thought that these lesions represent a spectrum of the same disease process rather than separate entities. The tumor commonly presents as an asymptomatic mass lesion and is usually well-circumscribed clinically so that conservative surgical excision has been the treatment of choice, but on occasion extended surgical procedures may become necessary, especially for those tumors which demonstrate rapid expansions and are poorly encapsulated (either initially or when recurrent) and when tumor growth is progressed aggressively or recurrent. En-bloc resection of mandible with iliac bone and inferior alveolar nerve graft was performed in case 1, recurrent cemento-ossifying fibroma of 32-year old male patient, and extended surgical enucleation of mass including normal marginal bone was done in case 2, recurrent ossifying fibroma of 72-year old female patient. By follow-up check of the patients, we obtained good result without any sings of recurrence.

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Clinical Analysis of Patients with Multiple Organ Injuries Who Required Open thoracotomy (개흉술이 필요했던 다발성 외상환자에 대한 임상적 고찰)

  • 이성광;정성운;김병준
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.804-810
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    • 1998
  • Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).

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Malignant Thrombi of Inferior Vena Cava from Renal Cell Carcinoma -4 cases reports- (신세포암에 의한 하대정맥 악성 혈전 -치험 4례-)

  • 홍종면;김오곤;이석재;노윤우;이조한;홍장수;김원재;임승운;안재호
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1097-1101
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    • 1998
  • Renal cell carcinoma involves the inferior vena cava(IVC) in approximately 5-10% of the patients. Presently surgical extirpation is the only form of therapy that can result in cure. Circulatory arrest with cardiopulmonary bypass is an operative technique that recently has been used to assist in resection of tumors that extend into the vena cava above the level of hepatic veins. We performed removal of tumor thrombi of IVC in 4 patients. All of them who had the renal cell carcinormas with infrahepatic vena caval extension were performed by standard surgical technique without cardiopulmonary bypass. But in one patient, inferior vena caval thrombectomy was done using circulatory arrest because of the recurred extension of the tumor thrombi within the vena cava above the insertion of the hepatic vein. All patients were recovered without any significant problems.

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