• Title/Summary/Keyword: 이식 전이

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Intercalary Tricortical Iliac Bone Graft in the Surgical Treatment of Nonunion of Midshaft Clavicular Fractures (쇄골 간부 불유합에서의 개재 삼면피질 장골 이식술)

  • Cho, Chul-Hyun;Jang, Hyung-Gyu
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.32-36
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    • 2012
  • Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after intercalary tricortical iliac bone graft with plate fixation for the nonunion of midshaft clavicular fractures. Material and Methods: Between September 2007 and May 2011, 10 patients who were treated by the intercalary tricortical iliac bone graft, with plate fixation for clavicle nonunion, were studied. The mean follow-up period was 30.7 (12~57) months. After the sclerotic bone was excised to the bleeding cortical bone, we interposed the tricortical iliac bone to provide structural support and restore clavicle length, and then fixed the plate and screws. The radiologic outcomes on the serial plain radiographs and clinical outcomes, according to UCLA, ASES and Quick DASH scores, were analyzed. Results: Bony union was obtained in all cases (100%) and the average union time was 18.4 (14~24) weeks. The average respective UCLA and ASES scores improved from 16.7 and 52.1 preoperatively to 27.4 and 83.6 postoperatively (p<0.05). The average Quick DASH score was 40.5, at the final follow-up. Complications were 2 shoulder stiffness, and one case had removal of device and arthroscopic surgery at 11 months, postoperatively. There were no implant failure or infection. Conclusion: Intercalary tricortical iliac bone graft, with plate fixation for the nonunion of midshaft clavicular fractures, is a good option that can provide structural support and restore clavicle length, as well as high union rate.

Autotransplantation of an impacted maxillary canine using Rapid Prototyping : A case report (Rapid Prototyping을 이용한 상악 매복 견치의 자가이식 치험례)

  • Cho, Nan-Ju;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.498-505
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    • 2007
  • Management options for impacted maxillary canines can include (1) continued observation, (2) extraction of the primary canine to aid spontaneous eruption, (3) uncovering and bonding of the impacted tooth and its eruption using orthodontic traction, (4) autotransplantation, and (5) extraction followed by prosthetic replacement. Autotransplantation should be considered when the degree of malposition is too severe to correct by orthodontic alignment. The present report describes the management of an ectopic eruption of the left maxillary canine in an 10-year-old girl. The treatment included the extraction of primary maxillary left canine and the autotransplantation using a Rapid Prototyping model. By using RP model to contour the recipient bone and check for fitting in the prepared socket, the extra-oral time can reduce. The autotransplanted canine showed mobility within normal limit, negative response to percussion and positive to electric pulp test after 6 months.

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Malignant Fibrous Histiocytoma in Sternum after Radiation Therapy -Total Sternectomy and Chest Wall Reconstruction, A Case Report- (방사선 치료후 흉골에 발생한 악성 섬유성 조직구종 -흉골 전절제 및 흉벽 재건술 1례 보고-)

  • 조유원;박승일
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.115-119
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    • 1996
  • Malignant fibrous histiocytoma after radiation therapy is very rare and its prognosis is poor. A 52-year-old male patient was admitted due to painful mass at the sternal area which developed 6 months ago. The patient had a history of radiation therapy for esophageal cancer 5 years ago. The incisional biopy disclosed sternal sarcoma. In spite of 5 cycles of chemotherapy, the m ss progressively enlarged, and an operation was performed. Total sternectomy with overlying skin and postal cartilage was performed and reconstruction was carried out with autologous rib bone graft, bilateral pectoralis klajor muscle flap and skin graft. The microscopic examination was consistent with malignant fibrous histiocytoma. The postoperative course was uneventful and the patient was discharged on postoperative 36 day.

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Surgical Treatments of Osteosarcoma around the Knee in Children (소아 슬관절 주위 골육종의 수술적 치료)

  • Nam, Kwang-Woo;Lee, Sang-Hoon;Kim, Han-Soo;Oh, Joo-Han;Cho, Whan-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.1-12
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    • 2004
  • Purpose: The current study was performed to analyze the oncological and functional results, and the patient, the limb and the prosthesis survival of osteosarcoma around the knee in children according to the treatment options. Materials and Methods: From 1982 to 2002, 63 patients with osteosarcoma around the knee underwent surgical treatments before 16 years of age. Surgical treatment options were amputation, endoprosthetic replacement, and implantation of low heat-treated autogenous bone graft after wide resection of tumor. The mean age of patients was 11.5 years (4.4~16), and the mean follow-up period was 6.1 years (2.1~16.8). All patients had neoadjuvant and adjuvant chemotherapy. All endoprosthses were extendible types. Anatomical locations of osteosarcoma were distal femur in 40 patients, and proximal tibia in 23 patients. As regard to Enneking stage, 4 patients had stage $II_A$, 50 patients had stage $II_B$, and 9 patients had stage III tumors. Results: The 5 year survival rate of stage $II_B$ patients was 72.7% in amputation, 83.7% in endoprosthesis, and 100% in low heat-treated autogenous bone graft. The 5 year survival rate of salvaged limb was 84.4% in endoprosthesis, and 80% in low heat-treated autogenous bone graft. The survival rate of prosthesis was 92.7% at 5 years, 67.4% at 10 years in endoprosthesis, and 75% at 5 years in low heat-treated autogenous bone graft. Mean functional outcome scores were 8.7 points in amputation, 20.6 points in endoprosthesis, and 16 points in low heat-treated autogenous bone graft. Distant metastasis occurred 15.8% in amputation, 27% in endoprosthesis and local recurrence occurred 8.1% in endoprosthesis, 14.3% in low heat-treated autogenous bone graft. Major complications happened 26.3% in amputation, 35.1% in endoprosthesis, and 28.6% in low heat-treated autogenous bone graft. Conclusion: Limb salvage procedure had functionally better results than amputation in children with osteosarcoma around the knee. Reconstruction with endoprosthesis after resection of tumor had good results in children as adults. In certain circumstances as too small bone for endoprosthesis or minimal bony destruction or too skeletally immature patient, low heat-treated autogenous bone graft may be a good treatment option. Low heat-treated autogenous bone graft may be considered as not only a substitute for endoprosthesis but also a temporary method before endoprosthesis.

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Porting Linux for PowerPC-based Embedded System (PowerPC에 기반한 내장형 시스템을 위한 리눅스의 이식)

  • 강경태;김태웅;박상수;신현식;장래혁
    • Proceedings of the Korean Information Science Society Conference
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    • 2000.10c
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    • pp.94-96
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    • 2000
  • 인터넷 등 통신의 발달과 맞물려 컴퓨터, 이동전화, 셋톱박스(STB), 디지털TV, 개인휴대단말기(PDA) 등 정보단말기의 네트워크화가 급진전되면서 $\ulcorner$내장형 리눅스$\lrcorner$가 최근 정보기술(IT) 분야의 새로운 키워드로 부상하고 있다. 내장형 시스템(Embrdded System)은 특정 기능을 수행하도록 설계된 초소형 운영체제를 탑재해 기능을 최적화한 것으로, 컴퓨팅 기능을 지닌 모든 장비는 내장형 시스템의 적용분야가 된다. 내장형 운영체제(OS)로는 리눅스, 윈도CE, 팜OS 등이 인기를 끌고 있으며, 최근 들어 리눅스를 이용한 내장형 시스템 개발이 활기를 띠고 있다. 본 논문에서는 특히 Motorola사의 MPC860 마이크로 프로세서를 이용한 내장형 시스템 플랫폼에 리눅스를 이식한 사례를 중심으로 리눅스 이식의 방향을 제시하고 있다.

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Changes of Serum IgM, IgG in Pig's Xenograft Perfusion and Immunofluorescence Changes of the Deposition of IgM, IgG in the Xenograft in Dogs (잡종견에서 돼지 신장과 폐를 이용한 혈액관류에서 수술 전.후 혈액의 IgM, IgG와 이식 장기의 IgM, IgG 침착 정도 변화)

  • Lee, Doo-Yun;Paik, Hyo-Chae;Jeon, Se-Eun;Kim, Eun-Young;Nam, Jin-Young;Hong, Soon-Won;Hwang, Jung-Joo;Wada, Hiromi;Bando, Toru
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.467-472
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    • 2007
  • Background: Lung transplantation is the definitive therapy for end stage lung disorders. The success of allogenic lung transplantation has led to an increasing shortage of donor lungs from humans, including cadavers, and attention has now turned to transplantation of lungs from other species. However, there are many biological hurdles when using organs from other species because of hyperacute rejection after discordant xenotransplantation. Material and Method: Pigs (n=6, weighing $20{\sim}30kg$ each) for the donors and mongrel dogs (n=6, weighing $20{\sim}28kg$ each) for the recipients were used in this experiment. The left kidney of a pig was perfused to a mongrel dog for 30 minutes through the femoral artery and vein of the dog, and the right kidney was perfused for 30 minutes sequentially. Then, both lungs of the pig were perfused to the dog through the pulmonary artery and left atrium with using the same time intervals. The levels of IgM and IgG were measured from the blood and specimens of the kidney and lung. Result: The average levels of serum IgM gradually decreased after the perfusion, but the average levels of serum IgG did not charge from before to after perfusion. The immunohistochemical findings revealed decreased deposition of IgG and IgM after the perfusion. Conclusion: We conclude that the levels of the serum natural antibodies would be decreased with pre-transplantation xenograft perfusion in the recipient and the occurrence rate of hyperacute rejection after transplantation would be decreased.

Auto-Segmentation Algorithm For Liver-Vessel From Abdominal MDCT Image Using Morphological Filtering (Morphological Filtering을 이용한 복부 MDCT 영상의 간혈관 자동 추출 알고리즘)

  • Park, Chun-Ja;Ryu, Gang-Min;Park, Jong-Won
    • Annual Conference of KIPS
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    • 2005.05a
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    • pp.819-822
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    • 2005
  • 본 연구는 MDCT 영상을 이용하여 인체의 장기인 간을 추출하고 그 간 내부의 혈관을 추출하는 알고리즘을 제안하였다. 간에는 2개의 주요혈관이 있는데 생체 간 이식 수술시 필수적인 간의 절개 비율 및 간 내의 혈관 모습들을 제공하여 의료진에게 수술 전 혈관 형태에 대한 정확히 정보를 파악하도록 함으로써 혈관의 손상을 최대한으로 줄일 수 있도록 하여 수술 성공률을 높이는데 중요한 역할을 할 수 있다. 간을 이식 할 때 기증자와 수혜자가 동시에 생존하기 위해서는 기증자의 간으 크기가 중요하며 둘다 생존하기 위해서는 기증자는 자신의 간의 35% 이상을 남겨야 하며 수혜자 또한 생존을 위해 자신의 간의 40% 이상에 해당하는 간을 이식 받아야 하는데 간 이식에 있어서 절단 부분을 결정하는데 중요한 중간 정맥을 찾아내어 보여 줌으로써 중간 정맥을 중심으로 3가닥의 굵은 혈관과 주변혈관의 손상을 최소화하고 비율을 잘 맞추어 절단 할 수 있도록 수술하는데 도움을 줄 수 있다. 각 혈관은 원형성과 다양한 각도를 갖는 막대형의 형태를 가지고 있다는 특징을 이용해 morphological filtering을 통해 추출한 후 조합하여 재구성을 하여 혈관의 모습으로 생성해 낼 수 있었다.

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Predetermination of Sex in Bovine Preimplantation Embryos Produced In virto using Micromanipulative Biopsy and PCR (미세조작 Biopsy와 PCR에 의한 착상전 소 초기배의 성 판정)

  • 서승운;이홍준;최승철;김기동;이상호
    • Journal of Embryo Transfer
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    • v.12 no.3
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    • pp.325-333
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    • 1997
  • 수정란이식의 주변기술인 초기배의 미세조작및 성 판정은 가축의 경우, 경제 형질의 유전적 개량에 크게 기여하였다. 본 연구는 미세조작 biopsy와 PCR에 의한 체외생산 소 초기배의 급속. 정확한 성 판정 기법을 확립하기 위해 실시하였다. 체외성숙 및 체외수정에 의해 생산된 소수정란은 소 난관상피세포와 공배양을 통해 8-세포부터 배반포시시까지 체외발생시킨 후 미세조작 biopsy에 이용되었다. 미세조작 biopsy 과정중에 약간의 형태적인 손상이 관찰되었지만 대부분의 demi-embryo는 정상적인 배반포와 나화배반포로 발생하였다. 8~16 세포, 상실배, 초기배반, 포 시기에서 미세조작 biopsy 후 확장 또는 나환배반포기시기까지의 발달율은 각각 62.8(27/43), 83.3(30/36) 및 80.9%(55/68)로 정상적인 초기배와 큰 차이가 없는 것으로 나타났다. 총 136개의 소 초기배로 부터 2~10개의 할구세포를 미세조작 biopsy에 의해 분리하여 소 특이와 Y-특이염기서열을 가진 두 쌍의 염기서열을 이용하여 PCR을 수해하였다. 이들중 112(82.4%)개를 성공적으로 성 판정하였으며, 암/수 비율은 각각 34.8(39/112)/65.2%(73/112)로 나타났다. 본 실험에서 얻은 결과는 확립된 소 초기배의 미세조작기술과 성 판정 방법을 통해 계획적인 암.수 송아지의 선별 생산뿐만 아니라 소 수정란 이식을 통한 유전적 개량을 촉진시키는데 효과적으로 이용될 수 있는 기술이 확립된 것을 보여주었다.

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Allogeneic Hematopoietic Stem Cell Transplantation in Juvenile Myelomonocytic Leukemia (연소형 골수단구성 백혈병에서의 동종 조혈 모세포 이식)

  • Yoo, Keon Hee;You, Dong Kil;Lee, Soo Hyun;Sung, Ki Woong;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.178-185
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    • 2005
  • Purpose : The purpose of this study was to evaluate the outcome of children with juvenile myelomonocytic leukemia(JMML) treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods : Eleven JMML patients aged 8-39 months underwent allo-HSCT. The sources of grafts were unrelated donors(n=7), HLA-matched siblings(n=3) and an HLA 1-antigen mismatched familial donor. All patients had received chemotherapy ${\pm}13$-cis-retinoic acid(CRA) before transplant, and CRA was used, posttransplant, in six patients. Results : Only three patients were in complete remission(CR) at the time of transplantation. Initial chimeric status revealed complete donor chimerism(CC) in five patients, mixed chimerism(MC) in five and autologous recovery(AR) in one. One patient with MC having persistent splenomegaly eventually turned to CC and CR after rapid tapering of cyclosporine, combined with daily use of CRA. An AR case relapsed shortly after transplant but was rescued with second, unrelated cord blood transplantation. Ultimately, six patients are alive, event-free, with a median follow-up of 15.5 months posttransplant. All three deaths occurred in patients who failed to achieve CC, leading to disease progression. Conclusion : We suggest that graft-versus-leukemia effect play an important role and CRA a possible role in posttransplant leukemic involution in JMML. In patients whose leukemic burden is still high with MC after transplant, early tapering of immunosuppressants and introduction of CRA might provide a chance of a cure for some patients.

The Clinical Outcomes after Embryo Transfer (ET) on Day 2 and Day 5 or Subsequent ET on Day 2-5, 2-6, 2-7, 3-5 and 4-7 in In Vitro Fertilization-ET Cycles (체외수정술에서 배아 이식 시기와 방법 (2일과 5일 및 2-5, 2-6, 2-7, 3-5, 4-7일 연속 이식)에 관한 연구)

  • Kim, Dae-Won;Park, Kee-Sang;Song, Hai-Bum;Lee, Taek-Hoo;Chun, Sang-Sik
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.1
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    • pp.31-37
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    • 2003
  • 연구목적: 일반적으로 IVF-ET에서 가장 높은 임신율을 얻는 방법은 5 day ET (배반포기 배아 이식)이지만 장기간 배양이 적절하지 못한 경우에는 $2{\sim}4$일째에 ET를 실시하고 나서 $5{\sim}7$일째에 배반포기에 도달한 배아를 재이식 (SET)하여, SET의 효용성에 대하여 조사하고자 실시하였다. 연구재료 및 방법: 48주기의 환자에서 회수한 난자와 수정란은 10%와 20% hFF가 첨가한 DMEM에서 이식 직전까지 각각 공배양하였다. 채란 2일 (group I, day 2 ET), 5일째 이식 (group II, day 5 ET) 또는 재이식 (group III, SET; 2-5, 2-6, 2-7, 3-5, 4-7일)을 실시하면서 수정률, 할구분할률 및 임신율을 각각 비교하였다. 결과에 대한 통계 분석을 SAS (version 6.2)를 이용한 Duncan's Multiple Range Test를 이용하여 p값이 0.05 보다 작을 때 통계적으로 유의차가 있는 것으로 하였다. 결 과: 수정률은 group II (90.5%)가 다른 군에 비하여 높게 (p<0.05) 나타났다 (group I: 80.6%; group III: 82.9%). 할구분할률은 군간에 차이가 없었다 (수정란 당 $93.3{\sim}99.1%$). 임상적 임신율은 group II와 III (각각 58.3%)가 group I (33.3%) 보다 높게 나타났다. 그러나 처리군이 적어서 통계적인 차이는 없었다. 결 론: 배반포기 배아를 단독 이식하는 것이 임신율을 높일 수 있는 최선의 방법으로 나타났지만, 채란수가 적거나 수정률이 저조한 경우에는 $2{\sim}4$일째에 ET를 실시한 후 여분의 배아를 배반포기까지 배양한 다음 $5{\sim}7$일에 재이식 (SET)하면 blastocyst ET에서 나타날 수 있는 이식 자체의 실패를 방지할 수 있으면서 임신율을 높일 수 있는 이식 기법이 될 것이다.