• 제목/요약/키워드: Bilateral surgery

검색결과 1,235건 처리시간 0.027초

자궁선종을 동반한 자궁근종에서 자궁동맥 색전술을 이용한 치료의 효과 (Uterine Arterial Embolization for the Treatment of Leiomyomas Accompanying with Adenomyosis)

  • 장진범;배상욱;임재학;이도연;김정연;정경아;김세광;박기현
    • Clinical and Experimental Reproductive Medicine
    • /
    • 제28권3호
    • /
    • pp.215-223
    • /
    • 2001
  • Objective: The purpose of this study was to make a guideline of uterine artery embolization for the treatment of uterine leiomyomas accompanying with adenomyosis in Korea. Materials and Methods : We performed the retrospective study for 37 women who had uterine leiomyomas accompanying with adenomyosis. Bilateral uterine artery embolization was performed in 37 patients (age range 25-65) during 17 months with pain, hypermenorrhea, urinary frequency etc due to leiomyomas. Ultrasound imaging was performed before the procedure and at mean 6.9 months after the procedure. Results: All procedures were technically successful. Mean clinical follow-up was 12.8 months. Minor complication occurred in 82% patients after the procedure. After imaging follow-up (mean, 6.9 months postprocedure), median uterine volume decreased 34.4%, and dominant myoma volume decreased 86%. There was no statistical difference in uterine volume reduction and dominant myoma size reduction whether occluding agents was polyvinyl alcohol, polyvinyl alcohol plus gelfoam, and gelfoam, and whether ultrasound measured Resistance Index value before the procedure was low or high. Conclusion: Primary candidates for uterine artery embolization include those with symptomatic uterine leiomyomas who no longer des ire fertility but wish to avoid surgery or are poor surgical risks. To our study, uterine volume reduction and dominant myoma size reduction in patients who had adenomyosis were similar to previous other studies in patients who had not adenomyosis. Therefore adenomyosis should not be considered as a contraindication for uterine artery embolization. Because there is little data about subsequent reproductive potential after this procedure, it should not be routinely advocated for infertile women. Further investigation is warranted for occluding agents and Resistance Index.

  • PDF

무수 알코올에 의한 내장신경차단에 관한 임상적 연구 (A Clinical Evaluation of Splanchnic Nerve Block with Absolute Ethanol)

  • 이효근;윤덕미;오흥근
    • The Korean Journal of Pain
    • /
    • 제4권2호
    • /
    • pp.111-121
    • /
    • 1991
  • It has been well known that the splanchnic nerve block is effective for patients who suffer from intractable upper abdominal pain. However, it is unclear whether the effect of the splanchnic nerve block depends on varied alcoholic concentration. In this study, an attempt was made to use absolute ethanol on patients who recieved a splanchnic nerve block at Severance Hospital during the period from September l990 to April l991. The results are as follows; 1) Among the 33 patients, including 22 males and 1l females, the fifties and sixties were the major age groups. 2) Stomach cancer was the most common underlying disease(13 cases), with pancreatic can- cer next(9 cases). 3) The main locations of pain were the upper abdomen, epigastrium, and entire abdomen in decreasing order. 4) There were 17 cases who had had chemotherapy, and 1l cases of whom had had surgery before the splanchnic nerve block. 5) The volume of alcohol used was 12 ml bilaterally. 6) Among the 33 patients, 15.2% required a second block within two weeks of the first block. One case required a third block. 7) The most common complications of splanchnic nerve block were hypotension(33.3%), occasional transient sharp burning pain, flushing of face, pain on injection site, nausea, vomiting, dyspnea, chest discomfort and diarrhea. 8) The supplemental block most commonly used was a continuous epidural block. It was used both as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 9) The interval between the receiving the absolute ethanol block and discharge was within 2 weeks in l5 cases. But, in the patients with poor general health, the interval between the splanchnic nerve block and discharge prolonged. The above results suggest that bilateral splanchnic nerve block done with absolute ethanol after an effective test block with 1% lidocaine under C-arm fluroscopic control is satisfactory and reliable. Still, 26.6% of the patients received a repeat block within 2 weeks. Insufficient spread of ethanol due to its small volume seems to be a major factor in the repeat block. Minimizing the incidence of repeat block remains a problem to be solved.

  • PDF

Cortical Network Activated by Korean Traditional Opera (Pansori): A Functional MR Study

  • Kim, Yun-Hee;Kim, Hyun-Gi;Kim, Seong-Yong;Kim, Hyoung-Ihl;Todd. B. Parrish;Hong, In-Ki;Sohn, Jin-Hun
    • 한국감성과학회:학술대회논문집
    • /
    • 한국감성과학회 2000년도 춘계 학술대회 및 국제 감성공학 심포지움 논문집 Proceeding of the 2000 Spring Conference of KOSES and International Sensibility Ergonomics Symposium
    • /
    • pp.113-119
    • /
    • 2000
  • The Pansori is a Korean traditional vocal music that has a unique story and melody which converts deep emotion into art. It has both verbal and emotional components. which can be coordinated by large-scale neural network. The purpose of this study is to illustrate the cortical network activated by a Korean traditional opera, Pansori, with different emotional valence using functional MRI (fMRI).Nine right-handed volunteers participated. Their mean age was 25.3 and the mean modified Edinburgh score was +90.1. Activation tasks were designed for the subjects to passively listen to the two parts of Pansories with sad or hilarious emotional valence. White noise was introduced during the control periods. Imaging was conducted on a 1.5T Siemens Vision Vision scanner. Single-shot echoplanar fMRI scans (TR/TE 3840/40 ms, flip angle 90, FOV 220, 64 x 64 matrix, 6mm thickness) were acquired in 20 contiguous slices. Imaging data were motion-corrected, coregistered, normalized, and smoothed using SPM-96 software.Bilateral posterior temporal regions were activated in both of Pansori tasks, but different asymmetry between the tasks was found. The Pansori with sad emotion showed more activation in the light superior temporal regions as well as the right inferior frontal and the orbitofrontal areas than in the right superior temporal regions as well as the right inferior frontal and the orbitofrontal areas than in the left side. In the Pansori with hilarious emotion, there was a remarkable activation in the left hemisphere especially at the posterior temporal and the temporooccipital regions as well as in the left inferior and the prefrontal areas. After subtraction between two tasks, the sad Pansori showed more activation in the right temporoparietal and the orbitofrontal areas, in contrast, the one with hilarious emotion showed more activation in the left temporal and the prefrontal areas. These results suggested that different hemispheric asymmetry and cortical areas are subserved for the processing of different emotional valences carried by the Pansories.

  • PDF

대뇌 신경교종증 : 임상특징 및 예후에 관한 연구 (Gliomatosis Cerebri : Clinical Features and Prognosis)

  • 조대철;황정현;성주경;황성규;함인석;박연묵;변승열;김승래
    • Journal of Korean Neurosurgical Society
    • /
    • 제30권12호
    • /
    • pp.1399-1405
    • /
    • 2001
  • Objectives : Gliomatosis cerebri is an uncommon primary brain tumor characterized by diffuse neoplastic proliferation of glial cells, with the preservation of the underlying cytoarchitecture. The aim of this study is to evaluate clinical features, outcome of surgical treatment and adjuvant therapy of gliomatosis cerebri. Methods : Between Jan. 1990 and Dec. 2000, 12 patients were diagnosed with gliomatosis cerebri based on characteristic radiological and histological findings. The patients' age ranged from 18 to 77(mean 44) years and the male to female ratio was 7 : 5. Nine patients underwent decompressive surgery and three, biopsy only. Postoperative radiation therapy was given in all cases except three. In addition to radiation therapy, four patients received chemotherapy. The mean duration of follow-up period was 18.8 months. Results : The most common presenting symptom were seizure and motor weakness. The mean duration of symptom was 5.9 months. There was 5 bilateral lesions and tumor involved corpus callosum in 5, basal ganglia-thalamus in 4, and brain stem in 2. There was no operative mortality but four patients died during the follow-up. The mean survival period for 11 patients was 20.5 months from the time of diagnosis. In univariate analysis, the lesion involving corpus callosum, basal ganglia-thalamus and brain stem correlated significantly with the short length of survival(p<0.05). Also, postoperative radiation as a adjuvant therapy prolonged the patient's survival(p<0.05). Conclusions : In the management of gliomatosis cerebri patients, early detection by MR imaging, active management of increased intracranial pressure, decompressive surgical removal and postoperative adjuvant therapy such as radiation is thought to be a good treatment modality.

  • PDF

흰쥐의 위궤양 발생에 미치는 뇌해마 제거 및 부신 적출의 영향 (Influence of Hippocampectomy and Adrenalectomy upon Gastric Ulceration in Rats)

  • 김명석;안병태;김철
    • The Korean Journal of Physiology
    • /
    • 제10권2호
    • /
    • pp.39-45
    • /
    • 1976
  • This study was conducted to see whether the hippocampectomy exerted facilitatory influence upon gastric ulceration in animals, and if so, whether the effect of hippocampectomy could be suppressed by adrenalectomy. 107 male rats were divided into 5 groups: rats that had over 90% of their hippocampal tissue removed through an opening on each side of the cerebral cortex(hippocampal group, N=21), rats that received bilateral adrenalectomy(adrenal group, N=29), rats that received adrenalectomy as well as hippocampectomy(hippocampo-adrenal group, N=10), rats that received damage to each side of the cortex over the hippocampus(cortical control group, N=20), and rats that had solely their head skin incised(normal control group, N=27). All rats were kept without restraint or food deprivation until on the 25th day after surgery, the stomach of each rat was inflated with 7ml of physiological saline and then removed under deep anesthesia. The mucosal surface was sketched under dissecting microscope, and enlarged photographs$(4{\times})$ were taken. The percentage of animals developing gastric ulcer in each animal group was calculated, the number of ulcer in each stomach was counted, and the total area of ulceration per stomach was measured on the Photograph with the aid of superimposed graph paper and expressed as permillage of total area of the glandular mucosa. Results obtained were as follows: 1. The percentage of animals developing gastric ulcer was significantly larger in the hippocampal group than they were in the hippocampo-adrenal, the adrenal, the cortical, and the normal control groups. 2. The mean number of ulcer per stomach was significantly larger in the hippocampal group than they were in the adrenal, the cortical control, and the normal control groups, while no significant difference existed between the hippocampal and the hippocampo-adrenal groups. 3. Total area of ulcer per stomach was significantly larger in the hippocampal group than they were in the cortical control and the normal control groups, but no significant differ-ence existed among the hippocampal, the adrenal, and the hippocampo·adrenal groups. 4. All measured values of the adrenal group were not significantly different from those of the hippocampo-adrenal, the cortical control, and the normal control groups. It is inferred from the above results that the hippocampus exerts an inhibitory influence upon gastric ulceration and that the hippocampal influence is mediated only partly through suppression of pituitary·adrenal activity.

  • PDF

전신성 홍반성 낭창에 병발된 비특이성 간질성 폐렴 1예 (A Case of Nonspecific Interstitial Pneumonia Associated with Systemic Lupus Erythematosus)

  • 이호명;황재경;박계영;박정웅;박재경;정성환;남귀현;이재웅;하승연;이한경
    • Tuberculosis and Respiratory Diseases
    • /
    • 제50권6호
    • /
    • pp.732-739
    • /
    • 2001
  • 교원성 질환에 병발하여 나타나는 간질성 폐렴은 여러가지가있으며, 이 중 비특이성 간질성 폐렴은 통상성 간질성 폐렴과는 달리, 예후가 좋고 스테로이드에 반응이 좋은 질병이다. 저자들은 전신성 홍반성 낭창에 동반된 비특이성 간질성 폐렴환자를 경험하고, 스테로이드를 써서 치료 후 외래에서 추적 관찰하는 1예가 있었기에 문헌 고찰과 함께 보고하는 바이다.

  • PDF

하악골과 방사선사진상에서의 하악절흔 내측 함요 (THE MEDIAL SIGMOID DEPRESSION: Its Anatomic and Radiographic Considerations)

  • 강병철
    • 치과방사선
    • /
    • 제21권1호
    • /
    • pp.7-13
    • /
    • 1991
  • 하악절흔 내측 함요는 하악골의 하악절흔 전, 내, 하방에 함몰된 양상으로 나타나는 정상 해부학적 구조물이다. 이 구조물에 대한 해부학적 중요성이나, 발생이 선천적인가 아니면 출생 후 발생되는 것인가에 대하여는 알려져 있지 않다. Langlais는 하악절흔내측함요는 파노라마 방사선사진상에서 절흔, 또는 소공 모양의 방사선투과상으로 나타난다고 하였지만 이는 하악사측방향 촬영상 등에서도 나타날 수 있는 해부학적 구조물이다. 파노라마 방사선사진에서는 익상판, 연구개, 기도, 그외 다른 조직 등의 중첩으로 인하여, 이 구조물의 발견 빈도가 낮아진다. 저자는 78개의 하악골에서의 발생빈도, 위치, 크기 등을 조사하고, 이를 파노라마 방사선사진촬영하여 그 발생 빈도를 조사하였으며, 치과환자 500명의 파노라마 방사선사진에서의 발생 빈도도 알아보았다. 1. 하악골에서의 발생빈도는 62%였다(편측성 28%, 양측성 33%). 2. 하악골의 파노라마 방사선사진상의 발생빈도는 33%였다(편측성 14%, 양측성 19%). 3. 하악절흔내측함요의 중심 위치는 하악절흔 하방 6.0㎜, 전방 3.8㎜였다. 4. 크기는 수직 7.8㎜, 수평 8.3㎜이였다. 5 치과환자들의 파노라마 방사선사진상에서의 발생 빈도는 24%였다(편측성 18%, 양측성 7%).

  • PDF

Benoist씨 장치를 이용한 소아의 하악 과두 골절의 치험례 (MECHANO THERAPY OF PEDIATRIC CONDYLAR FRACTURES USING BENOIST'S APPLIANCCE : A CASE REPORT)

  • 박상욱;차인호;김성오;최병재;최형준
    • 대한소아치과학회지
    • /
    • 제31권3호
    • /
    • pp.453-458
    • /
    • 2004
  • 소아에서의 하악 골절은 성인에서보다 드물다. 그러나, 어릴수록 강직과 성장장애의 가능성이 크며 성인만큼 악간고정을 잘 견뎌내지 못한다. 반면에, 골절은 소아에 있어 더 빨리 치유되고 합병증도 적다. 소아에서 하악 골절은 종종 하악의 acrylic splint therapy 단독 또는 eyelet wire 와 악간 고정을 같이 사용하여 성공적으로 치료될 수 있다. 발생할 수 있는 심각한 합병증으로는 유착과 성장장애가 있다. 이러한 합병증의 빈도와 심각성은 좀더 짧은 기간의 악간고정과 긴밀한 술 후 관리에 의해 감소될 수 있다. 특히 소아 환자가 악간고정을 잘 견디지 못하는 경우, 악간고정의 기간이 길어지는 경우, 환자의 자발적인 운동요법이 어려운 경우 악간고정이 불필요하고 개구장애 만을 일으킨 미약한 증상의 경우에는 동기부여에 의한 물리적 하악 운동요법이 사용될 수 있다. 본 종례에서는 하악정중부의 외상으로 인하여 양측성 과두 골절이 일어난 6세 여자 환아를 대상으로 상, 하악에 elastic을 이용하여 하악의 개구, 측방, 전방운동에 대해 훈련을 가능하게 하는 Benoist씨 장치를 이용한 능동적 하악 운동 요법으로 7개월 간의 정기 검진을 통하여 하악 운동량의 증진 과두 유착의 방지, 골개조의 치료효과를 보였다.

  • PDF

새기형(鰓畸形, Branchial Anomalies) - 대한 소아외과학회 회원을 주 대상으로 한 전국 조사 - (Branchial Anomalies in Korea - A Survey by the Korean Association of Pediatric Surgeons -)

  • 박우현;권수인;김상윤;김성철;김신곤;김우기;김인구;김재억;김현학;박귀원;박영식;박주섭;송영택;안우섭;오남근;오수명;유수영;이남혁;이두선;이명덕
    • Advances in pediatric surgery
    • /
    • 제2권2호
    • /
    • pp.119-128
    • /
    • 1996
  • The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients (43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(19) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50(78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.

  • PDF

결핵성 림프절염에 이차적으로 발생한 결핵성 요근 농양 1예 (A Case of Tuberculous Psoas Abscess Caused by Tuberculous Lymphadenopathy)

  • 박미연;박진영;유지연;김승수;김명숙;김지창;안창준
    • Tuberculosis and Respiratory Diseases
    • /
    • 제65권6호
    • /
    • pp.517-521
    • /
    • 2008
  • 저자들은 항결핵 치료 6개월 후 척추 결핵의 동반없는, 결핵성 림프절염에 의해 이차적으로 발생한 양측성 다발성 결핵성 요근 농양 환자 1예를 경험하였다. 환자는 한차례의 수술적 절개 및 배액술 그리고 여섯 차례의 경피적배액술과 2년간의 약물치료를 통해 완치되었고 이후 재발은 없어 이에 문헌 고찰과 함께 보고하는 바이다.