• Title/Summary/Keyword: 장골

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Surgical Treatment for a Primary Arterioenteric Fistula between a Common Iliac Artery Aneurysm and the Terminal Ileum with Massive Bleeding (대량출혈을 동반한 총장골동맥류와 회장 사이에 생긴 일차성 동맥-장관루의 치험)

  • Lee, Hyung-Chae;Jun, Hee-Jae;Choi, Kwang-Ho;Lee, Yang-Haeng;Hwang, Youn-Ho;Lee, Seong-Kwang
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.635-638
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    • 2009
  • A 72-year-old man with progressive, unexplained lower gastrointestinal bleeding presented to the emergency department with abdominal pain and shock. Computed tomography of the abdomen showed a fistula between a right common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm of the common iliac artery with a fistulous communication to the terminal ileum. Aneurysmectomy, aortoiliac graft replacement and segmental ileocecal resection with end-to-side anastomosis were all successfully performed. For a patient having an arterioenteric fistula along with lower gastrointestinal bleeding, making an early diagnosis using computed tomography and then performing immediate surgery can be expected to save the patient's life.

A Comparison between Ilioinguinal and Iliohypogastric Nerve Block and Infiltration of Local Anesthetics for Postoperative Pain after Inguinal Herniorrhaphy in Children (소아에서 서혜부탈장 수술 후 장골서혜신경 및 장골하복신경 차단술과 창상국소주사의 진통효과 비교)

  • Park, Dae-Geun;Lee, Nam-Hyuk
    • Advances in pediatric surgery
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    • v.20 no.1
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    • pp.7-11
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    • 2014
  • The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

Dose Assessment in Accordance with the Measured Position of Size Specific Dose Estimates (Size Specific Dose Estimates(SSDE)측정 위치에 따른 피폭선량 평가)

  • Kim, Jung-Su;Hong, Sung-Wan;Kim, Jung-Min
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.383-387
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    • 2015
  • This study investigated the size specific dose estimates of difference localizer on pediatric CT image. Seventy one cases of pediatric abdomen-pelvic CT (M:F=36:35) were included in this study. Anterior-posterior and lateral diameters were measured in axial CT images. Conversion factors from American Association of Physicists in Medicine (AAPM) report 204 were obtained for effective diameter to determine size specific dose estimate (SSDE) from the CT dose index volume (CTDIvol) recorded from the dose reports. For the localizer of mid-slice SSDE was 107.63% higher than CTDIvol and that of xiphoid-process slices SSDE was higher than 92.91%. The maximum error of iliac crest slices, xiphoid process slices and femur head slices between mid-slices were 7.48%, 17.81% and 14.04%. In conclusion, despite the SSDE of difference localizer has large number of errors, SSDE should be regarded as the primary evaluation tool of the patient radiation in pediatric CT for evaluation.

Clear Cell Chondrosarcoma of the Tibia Diaphysis: A Case Report (경골 간부에 발생한 투명세포연골육종: 증례 보고)

  • Kang, Chang Min;Han, Chung Soo;Jung, Gwang Young;Jeong, Ho Yeon;Kim, Young Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.89-93
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    • 2014
  • Clear cell chondrosarcoma is a very rare malignant bone tumor that shows a strong predilection for the epiphysis or metaphysis of long bones. Many studies have reported that the proximal end of the femur is the most commonly affected site, followed by the proximal end of the humerus. Histopathologically, tumor cells of this type have centrally located round nucleoli with clear cytoplasm and a distinct cytoplasmic membrane. Generally, clear cell chondrosarcomas is not confused with conventional chondrosarcomas. However, when it involves the diaphysis in long bones, diagnosis can be hindered, as only three reports of this exist in the literature. We report herein an unusual case of clear cell chondrosarcoma of the tibial diaphysis in a 42-year-old male.

RECONSTRUCTION COMBINED WITH HBO THERAPY AND ILIAC BONE GRAFT IN MANDIBULAR FRCTURE SITE OSTEOMYELITIS (하악골 골절후 이차감염으로 인한 골수염시 유리 장골 이식술과 고압산소 요법을 이용한 재건 치험례)

  • Kim, Su-Nam;Lee, Dong-kuen;Lim, Chang-Joon;Yun, Seong-Pill
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.110-116
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    • 1991
  • Fracture site osteomyelitis begins rarely with an acute event but rather has a subacute onset. It develops almost exclusively in the mandibular region. The treatment principles of mandibular fracture site osteomyelitis are complete removal of inflammatory tissue and drainage, rigid fixation with or without autogenous bone bone graft and specific antibiotic therapy. But hyperbaric oxygen used as a modality in the treatment of intractable osteomyelitis. In this paper, we reported that the three patients who have osteomyelitis accompying secondary in fection after mandibular fracture.

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Effectiveness Evaluation of Scanogram Using Longbone Detector (Longbone 검출기를 이용한 Scanogram의 유효성 평가)

  • Jang, Su-han;Heo, Ji-eun
    • Journal of radiological science and technology
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    • v.43 no.4
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    • pp.235-242
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    • 2020
  • Scanogram is that combine several practical images into one image to observation. So it is an important consideration in many clinical situation such as iliac measurement, leg alignment measurement and Scoliosis. Currently, scanogram examinations are mainly conducted for children and elderly patients. In this study, in order to apply the longbone detector to children or elderly patients who are difficult to cooperate with, we compared the longbone detector from D equipment with the G equipment discovery 656 Puls equipment in reproducibility of images, distribution of irradiation dose, scattering dose, irradiation time and image acquisition time. D equipment took more than twice as much time as G equipment. The scattered dose generated about 50% more G equipment than D equipment. In the whole spine scanogram and the measurement length of the lower leg, D equipment was also measured longer than G equipment. However, both methods did not show much difference from the CT scanogram, so there was no problem in measurement. The height of the thyroid radiation dose of G equipment was produced more radiation than D equipment. However, the longbone detector deviated from the x-ray center line relative to the tube rotation method, and was measured lower by the directionality of the measuring instrument, so that the error could not be corrected. In the conclusion of study, using the longbone detector is excellent for applying to children or elderly patients to reduce scattering dose. However, using CR may be useful to normal patients. Because, the image quality may deteriorate due to an imbalance of dose difference in thickness depending on the body part. So, it is useful to using a compensation filter or tube rotation method when we take a whole spine scanogram.

A CLINICAL COMPARATIVE STUDY BETWEEN ANTERIOR ILIAC AND PROXIMAL TIBIAL METAPHYSIS PARTICULATED CANCELLOUS BONE GRAFTS (장골과 경골의 자가입자망상골 이식에 관한 임상적 비교연구)

  • Oh, Sung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.228-231
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    • 1998
  • This is a clinical and retrospective study of 36 patients received the autogenous particulated cancellous bone grafts from anterior iliac and proximal tibial metaphysis and we compared the clinical postoperative complications in operation sites and donor site morbidity. The results of this study indicate that, in all our patients, the proximal tibia provided an adquate volume of cancellous bone and there were no special contraindications, in choosing and using the proximal tibia as a donor site in most oral and maxillofacial cancellous bone graft surgeries. Furthermore, the proximal tibial metaphysis would appear a more easily obtainable cancellous bone source and offer a superior clinical results than anterior iliac crest in donor site morbidity.

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MANDIBULAR RECONSTRUCTION WITH THE COMBINATION OF PMCB AND CORTICAL BONE IN TITANIUM MESH TRAY (자가 입자 골수 망상골과 치밀골을 이용한 하악골 재건술-증례보고 1례-)

  • Yi, Chung-Guk;Park, Hyeong-Rae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.3
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    • pp.87-91
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    • 1990
  • This is to report a case of secondary reconstruction after partial mandibulectomy by using of marrow-cancellous bone and cortical bone harvested from the iliac crest in the case of an ameloblastoma on the mandible. According to the past experimental studies, the marrow and cancellous bone have the marked osteogenic potential of hematopoietic. And the cortical bone has the highest activity of bone induction, which is mediated through the action of bone morphogenic protein(BMP). This grafting technique, the combination of PMCB and cortical bone, has advantage in restoring lange defect of the mandible.

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Pain Around the Posterior Iliac Crest of Thoracolumbar Origin -Case report- (흉요추 이행부 원인에 의한 후장골릉 부근 요통 -증례 보고-)

  • Hwang, Young-Seob;Oh, Kwang-Jo;Kim, Woo-Sun;Choe, Huhn
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.111-114
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    • 2000
  • Pain around the posterior iliac crest area is usually attributed to disorders of the lower lumbar or lumbosacral spine. However, low back pain arising from the thoracolumbar region is common and it is very similar to low back pain of lumbosacral origin. Low back pain of thoracolumbar origin is clinically distinguished from other nonspecific low back pain syndrome. It is characterized by symptoms localized at one posterior iliac crest innervated by posterior branch of $T_{12}$ spinal nerve. Patients never complain of spontaneous pain at the thoracolumbar junction. Only localized tenderness over involved segments of thoracolumbar junction can be noted. We report two cases of posterior iliac crest pain of thoracolumbar origin which was relieved by the treatment on the thoracolumbar junction.

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