• Title/Summary/Keyword: 제한적 절제술

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Debridement Arthroplasty using Posteromedial Approach in Elbow Joint with Pain and Bony Limitation of Motion (동통과 골성 운동 제한이 있는 주관절에서 후내측 도달법을 이용한 변연 절제 관절 성형술)

  • Cheon, Sang-Jin;Lee, Dong-Ho;Cha, Seung-Han;Kim, Hui-Taek;Suh, Jeung-Tak
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.67-75
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    • 2009
  • Purpose: This study evaluated the clinical outcomes of debridement arthroplasty using the posteromedial approach in elbow joints with pain and bony limitation of motion. Materials and Methods: This study involved 16 elbows in 16 patients with pain and bony limitation of motion, which were treated by debridement arthroplasty using the posteromedial approach from March 2005 to March 2008. The mean follow up period was 27.6 (13~52) months. The clinical outcomes were analyzed using the Visual Analogue Scale(VAS) for pain scale, the preoperative and postoperative range of motion and the Mayo Elbow Performance Scores(MEPS). Results: The VAS was decreased significantly from a preoperative mean of 4.5 to a postoperative mean 1.1 (p<0.001). The average arc of motion improved significantly from $61.6 (0~90)^{\circ}$ preoperatively to $109.4 (80-120)^{\circ}$ postoperatively (p<0.001). The MEPS also improved significantly from 59.4 to 85.6 postoperatively (p<0.001). There were no complications, such as hematoma and elbow instability. Conclusion: Debridement arthroplasty using the posteromedial approach is a useful surgical procedure in the elbow joint with pain and bony limitation of motion, where all compartments can be debrided, the ulnar nerve can be manipulated easily and damage to the medial collateral ligament can be minimized.

Thoracoscopic Sympathetic Surgery for Axillary Hyperhidrosis (액와부다한증에서의 흉부교감신경절제수술)

  • 홍윤주;이두연;백효제;신화균;황정주;정은규
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1106-1110
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    • 1999
  • 배경: 다한증의 치료에 있어서 흉강경을 이용한 교감신경절제술의 시술 빈도가 급증하고 있다. 그러나 액와부 다한증의 경우 수장부나 안면 두부다한증에 비하여 절제범위가 광범위하여 이에 따른 보상성 다한증 및 기타 합병증의 발생의 높고 액취증이 동반되어있는 경우 장기적인 만족도가 낮아서 크게 각광 받지 못해왔다. 대상 및 방법: 본 교실에서는 1997년 3월부터 1999년 4월까지 45례의 액와부 다한증 환자에서 2 mm 흉강내시경을 이용하여 흉부교감신경절제술 또는 잘단술을 시행하였다. 남자 28례 여자 17례로 평균연령은 28(13-46세) 였고 평균추적기간은 10개월(1-24)이었다. 24례가 액와부에만 국한된 과도발한을 호소 하였고 2례에서 수술 전 심한 액취증이 동반되어있었다. 21례의 T3,4 교감신경절제술, 20례의 T2,4 교감신경단술 그리고 4례의 T4 교감신경절제수을 시행하여 즉각적인 증상치유효과 보상성 다한증 및 장기적 만족도를 비교 분석하였다. 중등도 이상의 흉막유착으로 5mm 내시경이 필요했던 2례을 제외한 전 환자에서 2mm 트로카 2개를 사용하여 수술을 하였다 결과: 평균수술시간은 T3,4 교감신경절제술이 46.2$\pm$11분 T2, 4 교감신경절단술이 32.5$\pm$23분 T4 교감신경절제술이 53.8$\pm$18분이 소요되었고 수술직후의 효과는 T3,4 교감신경절제술과 T2,4 교감신경절단술에서 '전혀땀이 나지 않는다'가 17례(81%) 와 12례(60%) '수술전보다 감소했으나 약간땀이 난다'가 4례(19%) 와 8례(40%) 로 모든 환자에서 효과가 있었으나 T4 교감신경절제술은 4례중3례(75%)에서 전혀 효과가 없었다. 보상성 다한증은 T3,4교감신경절제술과 T2,4 교감신경절단술에서 각각 67%, 60%로 나타났고 생활에 불편을 줄 정도의 심한경우는 10% 5%에 불과했으며 장기적인 만족도는 T3,4 교감신경절제술이 86% T2,4 교감신경절단술이 89%로 나타나 높은 성공률을 보았다 결론 : 액와부다한증의 치료에 있어서 T3,4 교감신경절제술과 T2,4교감신경절단술은 증상치유효과가 높고 절제범위의 제한에 따른 보상성 다한증의 감소로 장기적 만족도가 우수한 효과적인 방법이다. 액취증이 동반된 경우 이에대한 충분한사전 설명과 원인 감별후 적절한 보조요법을 병행함으로써 환자의 만족도를 높힐수 있다고 본다.

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Outcomes of Meniscal Allograft Transplantation (동종 반월상 연골 이식술의 결과)

  • Cho, Chong-Hyuk;Choi, Yun-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.36-41
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    • 2011
  • Treatment options are limited for young, meniscal-deficient patients with pain. This patient population is not age appropriate for total joint replacement, but the loss of the meniscus leaves them at significant risk for the development of osteoarthritis. One increasingly popular option is the use of allograft meniscal transplantation. However, many questions still surround allograft meniscus transplantation. Furthermore, most reports in the literature on the results of meniscal transplantation describe small case series using clinical outcome measures and/or incomplete direct evaluation of the meniscus. Therefore, the results of meniscal allograft transplantation have been difficult to interpret and compare due to many confounding variables. In this study, we reviewed the current research of concerns on the results of meniscal allograft transplantation.

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Role of Limited Partial Parotidectomy in the Management of Benign Parotid Tumors (이하선 양성종양에서 제한적 부분 이하선 절제술의 유용성)

  • Jung, Sung-Do;An, Se-Young;Park, Byung-Kuhn;Lee, Sang-Joon;Chung, Phil-Sang
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.1
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    • pp.54-58
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    • 2011
  • Objectives : There are many reports on attempts to minimize complications and recurrences of tumor by several techniques for benign parotid tumor resection. The purpose of our study is to find out meaning of procedure without identifying main trunk of facial nerve compared to conventional parotidectomy. Material and Methods : We classified 121 patients into two groups. Patients who were underwent superficial parotidectomy or partial superficial parotidectomy were included in idenitification group(IF group), and patients who were treated with conservative partial parotidectomy or extracapsular dissection without identification of main trunk of facial nerve were included in the non-identification group(NF group). We analyzed the location of tumor, operation time, mean drainage duration, complication, recurrence and cosmetic satisfaction in two groups. Results : NF group has shorter operation time and mean drainage duration than IF group, however there is no significant difference in complication and recurrence between two surgical techniques. The Cosmetic satisfaction was similar between two groups. Conclusion : Limited parotidectomy without finding main trunk of facial nerve may be reliable option for benign parotid tumors because it has advantages such as less operation time and mean drainage duration without increasing in recurrence or complication rate.

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.

One-Stage Ascending, Arch. and Descending Thoracic Aorta Replacement Through Median Sternotomy (정중 흉골 절개술을 통한 상행, 궁부, 하행 대동맥 동시 치환 수술례)

  • 이재원;이용직;이상권;주석중;윤석원
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.675-679
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    • 2002
  • In patient with severe adhesion between lung and aorta, there is some limitation in approaching the distal arch or descending thoracic aorta through the usual left thoracotomy. We report a case of a successfully managed distal arch and descending thoracic aortic aneurysm through the median sternotomy without any manipulations of the lung in a 66 year old man who presented hemoptysis.

A Systematic Review on Rehabilitation Research for Improving the Range of Motion of Shoulder Joint Motion in Patients with Breast Cancer Resection (유방암 절제술 환자의 어깨 관절가동범위 증진을 위한 재활 연구에 관한 체계적 고찰)

  • Park, Bo-Ra
    • Journal of Convergence for Information Technology
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    • v.10 no.11
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    • pp.257-264
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    • 2020
  • The purpose of this study is to investigate the types and effects of rehabilitation by systematically examining the rehabilitation research for improving the shoulder ROM in breast cancer resection patients. For a systematic review, a total of 8 studies were finally selected through three databases including RISS. As a result of this study, the level of qualitative was 4 studies(50.0%) in level III, and the rehabilitation period varied from 4 weeks to 12 weeks. As for the type of rehabilitation, 3 studies(37.5%) were occupational therapy and physical therapy. The ROM of the shoulder joint was 7 studies(87.5%) of flexion, extension, and external rotation. A goniometer was used in 8 studies(100.0%) to evaluate the ROM of the joint as a measuring tool. This study is expected to provide basic data in the field of convergence when developing and applying interventional protocols for patients with limited ROM due to breast cancer resection.

LINGUAL FRENECTOMY UNDER ORAL SEDATION (경구 진정요법하에 시행한 설소대 절제술)

  • Jang, Yong-Gul;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.568-574
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    • 2009
  • Tongue-tie is a congenital anomaly characterized by an abnormally short lingual frenum, which may restrict tongue tip mobility, In the neonate and infant, tongue-tie was said to cause difficult breast-feeding, In the older infant, toddler and young child, poor speech has been frequently listed because movement of tongue tip is limit ed. Also as a abnormal tongue position, various orthodontic problems, later mechanical and social manifestations could be developed. Treatment options such as observation, speech therapy, frenotomy and frenectomy have been suggested. The optimal timing for the surgery has not been determined, but early intervention may be appropriate for the children with significant tongue-tie who has the significant potential to speech difficulties and later social and mechanical problems. Sedation is an effective method for incapable of cooperative and the handicapped children, necessary to early intervention. We report three cases, using oral sedation for the frenectomy in young children with severe tongue-tie. After treatments, we could find out sufficient tongue movement and improved speech ability.

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Evolving Indication of Meniscal Allograft Transplantation (진화하고 있는 동종 반월연골판 이식술의 적응증)

  • Lee, Bum-Sik;Bin, Seong-Il;Kim, Taehyung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.200-209
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    • 2020
  • The first human meniscal allograft transplantations (MATs) were performed 30 years ago. In the early era, candidates were limited to patients who have favorable joint conditions. MAT is currently indicated for patients with post-meniscectomy symptoms, such as compartmental pain or effusion after a subtotal or total meniscectomy. The current indication for MAT is being expanded to other patients who were not indicated previously. The present article reviews how the indications of MAT have changed over the years.

Outcomes of Diffuse-Type Pigmented Villonodular Synovitis (PVNS) after Open Total Synovectomy (미만형 색소 융모 결절성 활액막염의 관혈적 활막 전 절제술 후 경과)

  • Lee, Mo-Ses;Lee, Soo-Hyun;Suh, Jin-Suck;Yang, Woo-Ik;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.27-36
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    • 2010
  • Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.