• Title/Summary/Keyword: 확장술

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BALLOON DILATATION OF ESOPHAGEAL STRICTURE (Balloon 확장술에 의한 식도협착증의 치료)

  • 윤성철;나인국;김형종;노영수;임현준;이길우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.33-33
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    • 1991
  • 부식성 식도염에서 속발한 식도협착의 비외과적 치료법으로 사용되었던 종래의 각종 소식자를 이용한 확장술은 그 효과가 일시적이며 소아에서 시행시 많은 문제점이 있다. 근래들어 관상동맥, 요관, 대장 등의 협착에 사용되어온 balloon Catheter를 이용한 식도 확장술은 비교적 안전하고 효과적이어서 소아나 정도가 심한 식도협착의 치료에 큰 도움을 줄 수 있다. 본 교실에서는 최근 2년간 부식성 식도염 후 속발한 식도협착 6 례를 Balloon catheter 확장법으로 치료하여 아래와 같은 결과를 얻었기에 보고하는 바이다. 1) 전체 6명 중 남자가 4명 여자가 2명으로 평균 연령은 45.7세였다. 2) 부식제의 종류는 가성소다가 5명 초산이 1명이였다. 3) 협착부위는 1례가 경부식도이며 5례가 흉부식도였고 이중 1례는 다발성 협착이 였다. 4) 확장 전 식도조영사진 상 협착부위의 평균 내경은 4.3mm였다. 5) 확장술을 시행한 횟수는 2회에서 5회( 평균 3.5회 )로 확장술이 끝난 후의 평균 내경은 13.5mm였다. 5) 확장술시 3례에서 식도파열이 발생하였으나 보존적 치료법으로 치유되었다.

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Horizontal Ridge Augmentation using Ridge Expansion and Autogenous Tooth Bone Graft: A Case Report (치조능확장술과 자가치아골이식술을 이용한 치조능 수평증대술: 증례보고)

  • Kim, Young-Kyun;Yi, Yang-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.1
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    • pp.109-115
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    • 2011
  • Implants were placed after performing ridge expansion by inserting screws of gradually increasing thickness. Favorable clinical outcome was obtained. During surgery, buccal cortical plate fracture did not occur. Autogenous tooth bone graft material was grafted around the implant dehiscence defects and over the buccal cortical plate. The method involving the insertion of screws for ridge expansion is a successful and predictable technique for implant placement in narrow alveolar bone. Autogenous tooth bone graft material can be used for ridge augmentation and GBR.

A posteroanterior cephalometric study on the change of maxilla by rapid palatal expansion (상악골 급속 확장 후 상악골 변화에 대한 정모두부방사선 규격사진 분석에 관한 연구)

  • Kim, Young-Joon
    • The korean journal of orthodontics
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    • v.29 no.3 s.74
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    • pp.375-381
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    • 1999
  • The purpose of this study was to evaluate whether the basal bone of maxilla was expanded transversely by rapid palatal expansion through the posteroanterior cephalome- tric analysis. Thirty patients with the maxillary deficiency were utilized in this study. The posteroanterior cephalometric X-ray film were taken twice, before and after rapid palatal expansion. logram The obtained results were as follows; 1. There was a significant increase of the maxillary width by rapid palatal expansion in male and female. (P<0.001) 2. There was no significant difference between the male and female in the expansion of the maxillary width by rapid palatal expansion. 3. There was a significant increase of the maxillary width by rapid palatal expansion in the both of before and after the puberty. 4. There was no significant difference between before and after the puberty in the expansion of the maxillary width by rapid palatal expansion.

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Congenital Pulmonary Vein Stenosis with Normal Anatomical Connection -One case report- (정상적인 해부학적 연결을 가진 선천성 폐정맥 협착증 -치험 1예 보고-)

  • 박준석;장윤희;정미진;강이석;전태국
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.364-368
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    • 2004
  • Congenital pulmonary vein stenosis is a rare anomaly and related to high mortality due to progressive pulmonary hypertension and heart failure in infancy. Aggressive anti-failure medication and surgical treatment is recommended. Surgical options are balloon dilatation, endovascular stent, pneumonectomy, lung transplantation, patch grafting, and sutureless repair. We report a case of congenital pulmonary vein stenosis with normal anatomical connection successfully treated with sutureless technique and using pulmonary vasodilators, such as Sildenafil, lloprost and iNO postoperatively.

Usefulness of $^{201}Tl$ Myocardial Perfusion SPECT in Prediction of Left Ventricular Remodeling following an Acute Myocardial Infarction (급성심근경색 후 발생하는 좌심실 재구도 예측에 대한 $^{201}Tl$ 심근관류 SPECT의 운용성)

  • Yoon, Seok-Nam;Park, C.H.;Hwang, Kyung-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.30-38
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    • 2000
  • Purpose: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. Results: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. Conclusion: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.

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Pelvic Symphyseal Distraction Osteotomy for Constipation Management Secondary to Pelvic Stenosis (골반강 협착증으로 인해 발생한 변비를 가진 고양이에서의 골반강 확장술을 이용한 치료 증례)

  • Oh, Kwang-Seon;Choi, Sung-Jin;Kim, Nam-Soo;Kim, Min-Su;Lee, Ki-Chang;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.527-530
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    • 2014
  • A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.

Partial Left Ventriculectomy as a Bridge to Cardiac Transplantation in a Patient of End-Stage Heart Failure -Case Report- (말기 심부전 환자에서 심장이식의 교량으로서 좌심실 축소술 - 중례보고 -)

  • 전양빈;이창하;이재웅;박철현;박국양
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.672-674
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    • 2002
  • A 40-years-old male with dilated cardiomyopathy(DCMP) and end-stage heart failure had undergone partial left ventriculectomy(PLV) in July 1997 and then underwent cardiac transplantation in January 1999. Three months later he showed increased ejection fraction (EF) from 26% to 42.6%, decreased left ventricular end diastolic diameter(LVEDD) from 71mm to 45mm, cardiac output(CO) 3.95 L/min and cardiac index(CI) 2.28 L/min/m$^2$echocardiographically. Eight months later, left ventriclular end diastolic and systolic diameters increased to 56 and 51 mm respectively and EF decreased to 17% in echocardiographic follow-up. He had been on maximum medication until he underwent cardiac transplantation 18 months after the PLV. Consecutive myocardial biopsies (1, 3 and 6 month later) showed ISHLT (international society of heart and lung transplantation) class la and the treatment for rejection was not needed until now on. We report a partial left ventriculectomy as a successful bridge to cardiac transplantation in a patient with DCMP and end-stage heart failure.

Small Aortic Annulus in Aortic Valve Replacement; Comparison between Aortic Annular Enlargement Group and Patient-prosthesis Mismatch Group (협소한 대동맥판륜 환자에서의 대동맥판막 치환술; 대동맥판륜 확장술군과 환자-인공판막 부조화군의 비교)

  • Kim, Jae-Hyun;Oh, Sam-Sae;Yie, Kil-Soo;Shin, Sung-Ho;Baek, Man-Jong;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.200-208
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    • 2007
  • Background: The effect of patient-prosthesis mismatch (PPM) on the clinical outcome following aortic valve replacement (AVR) remains controversial. This study compared the surgical outcomes of AVR between patients with a patient-prosthesis mismatch and those having undergone an aortic annular enlargement. Material and Method: Six hundred and twenty seven adult patients, who underwent AVR with stented bioprosthetic or mechanical valves, between January 1996 and February 2006, were evaluated. PPM was defined as an indexed effective orifice area (iEOA) ${\leq}0.85cm^2/m^2$, and Severe if the iEOA${\leq}0.65cm^2/m^2$ PPM was present in 103 (16.4%, PPM group) patients, and severe in 11 (1.8%, SPPM group). During the period of the study, 21 patients underwent an AVR with annular enlargement (AE group). Result: The mean iEOA of the AE group was larger than that of the PPM group ($0.95\;vs.\;0.76cm^2/m^2,\;p=0.00$). The AE group had longer CPB, ACC and operation times than the PPM group, and showed a tendency toward higher operative mortality (14.3% vs. 2.9%, p=0.06). The SPPM group had higher AV pressure gradients (peak/mean) than the AE group (72/45 mmHg vs. 38/25 mmHg, p=0.02/0.06) and suffered more AV related events (AV reoperation or severe aortic stenosis)(45.5% vs. 9.5%, p=0.03). LV masses were not regressed in the patients who experienced an AV related event. Conclusion: During AVR in patients with a small aortic annulus, annular enlargement should be carefully applied taking into account the high risk of operative mortality due to annular enlargement and co-morbidities of patients. Aortic annular enlargement; however, should be considered as an alternative method in patients expected to have a severe PPM after an AVR.

Expansive Laminoplasty for Cerical Compression Myelopathy (경수 압박으로 인한 척수증 환자에서의 경추강 확장술)

  • Han, Dong-Ro;Doh, Eun-Sig;Kim, Oh-Lyong;Chi, Yong-Chul;Choi, Byung-Yearn;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.141-146
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    • 1989
  • In an attempt to eliminate some negative aspects of conventional extensive laminectomy, 4 cases of multiple level of cervical compression myelopathy, 1 OPLL(ossification of posterior longitudinal ligament) and 3 cervical stenosis, were treated with a technique of expansive laminoplasty. Operative results in all patients were satisfactory without surgical complications and all patients had a neurological improvement. We suggest that our technique is more effective one for cervical canal enlargement with preservation of stability for treating multiple level of cervical canal stenosis, OPLL, and spondylosis than conventional extensive laminectomy.

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