• 제목/요약/키워드: Conservative surgery

검색결과 1,162건 처리시간 0.027초

귀비탕(歸脾湯)으로 호전된 뇌경색을 동반한 하지정맥류 환자 치험 1례 (A Case of Varicose Veins of the Lower Limbs with Cerebral infarction Treated with Guibi-tang)

  • 이해연;조현석;김정철;이재은;이재준;배동주;공경환;백태현;박정한
    • 대한한방내과학회지
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    • 제25권3호
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    • pp.633-639
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    • 2004
  • A varicose vein of the lower limbs is dilated, tortuous and elongated vein. Western medical treatment involves conservative management, sclerotherapy, and surgery. Currently, internal medicinal treatment is inadequate. Recently a patient was diagnosed with varicose veins of the lower limbs based on clinical symptoms. In this case, Guibi-tang was administered and clinical symptoms improved. This report suggests that oriental medicinal treatment is efficacious in treating varicose veins of the lower limbs. We think that further oriental medical studies on various surgical diseases are needed.

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심장 전이와 비후성 골관절증을 동반한 재발성 이하선 선방세포암 (Recurrent acinic cell carcinoma in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy)

  • 정성윤;이동원;구민근;권태훈;고성애;최준혁;손장원;현명수
    • Journal of Yeungnam Medical Science
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    • 제31권1호
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    • pp.33-37
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    • 2014
  • Acinic cell carcinoma (ACC) is an uncommon malignant tumor of the salivary glands that is difficult to diagnose. It grows slowly and shows distant metastasis rarely. We experienced a case of recurrent ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy. The 29-year-old man had been suffering from severe multiple bones and joints pain for 2 months. Ten years earlier, he underwent superficial parotidectomy due to a right subauricular mass. The mass was diagnosed with ACC. After surgery, the tumor recurred twice. Then the patient was diagnosed with cardiac metastasis via positron emission tomography-computed tomography and trans-thoracic echocardiography. He also had hypertrophic osteoarthropathy with multiple bone metastasis. He was given palliative radiotherapy and conservative treatment. ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy has not yet been reported in literature. From this case, it is recommended to evaluate multiple distant metastasis in the ACC of the parotid gland when joint and bone pain are present.

Strategy for Management of Giant Invasive Pituitary Adenoma

  • Yang, Hee-Seok;Kim, Oh-Lyong;Kim, Min-Soo;Kim, Sang-Woo;Chang, Chul-Hun;Cho, Soo-Ho
    • Journal of Korean Neurosurgical Society
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    • 제37권1호
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    • pp.25-28
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    • 2005
  • Objective: Giant invasive pituitary adenoma looks histologically benign, but these tumors have an aggressive clinical course. The authors review 10 cases and discuss the results obtained and the strategy to use for the management of giant invasive pituitary adenoma. Methods: Out of a series of 155 pituitary adenomas treated surgically between 1994 and 2002, ten patients with giant invasive pituitary adenoma were selected and their clinical problems, radiologic findings, extent and invasiveness, hormonal and histologic findings and surgical results were analyzed retrospectively. Results: There were 4 male and 6 female patients, with an average age of 47 years and an average follow-up period of 42 months. The average size of tumor was 50.7mm. These tumors revealed severe invasions into surrounding structures. 8 patients underwent transsphenoidal approach(TSA) operations, 1 patient with transcranial operation and 1 patient with combined TSA and transcranial operation. In all cases, subtotal resection was performed. The histologic findings were 2 prolactinomas and 3 hormonal non-function adenomas. The therapies administered after surgical removal consisted of conventional fractionated radiotherapy (2 patients), treatment with dopamine agonists to control hyperprolactinemia (2 patients), and treatment with hormone replacement (2 patients). Conclusion: Giant invasive pituitary adenomas are characterized by different forms of expansion and invasiveness and variable clinical problems. Because of their aggressive expansion and invasiveness, there are many different strategies which can be considered for their management. The authors obtain good results by choosing conservative surgical removal and multidisciplinary treatments with serial radiological and hormonal follow-up.

Interferon Stimulated Gene - ISG15 is a Potential Diagnostic Biomarker in Oral Squamous Cell Carcinomas

  • Laljee, Rupesh Puthenparambil;Muddaiah, Sunil;Salagundi, Basavaraj;Cariappa, Ponappa Muckatira;Indra, Adarsh Surendran;Sanjay, Venkataram;Ramanathan, Arvind
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.1147-1150
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    • 2013
  • Background: Cancer diagnostic biomarkers have a wide range of applications that include early detection of oral precancerous lesions and oral squamous cell carcinomas, and assessing the metastatic status of lesions. The interferon stimulated ISG15 gene encodes an ubiquitin-like protein, which conjugates to stabilize activation status of associated proteins. Hence a deregulated expression of ISG15 may promote carcinogenesis. Indeed overexpression of ISG15 has been observed in several cancers and hence it has been proposed as a strong candidate cancer diagnostic biomarker. Given the emerging relationship between malignant transformation and ISG15, we sought to examine the expression pattern of this gene in tumor biopsies of oral squamous cell carcinoma (OSCC) tissues collected from Indian patients. Materials and Methods: Total RNA isolated from thirty oral squamous cell carcinoma tissue biopsy samples were subjected to semi-quantitative RT-PCR with ISG15 specific primers to elucidate the expression level. Results: Of the thirty oral squamous cell carcinomas that were analyzed, ISG15 expression was found in twenty four samples (80%). Twelve samples expressed low level of ISG15, six of them expressed moderately, while the rest of them expressed very high level of ISG15. Conclusions: To the best of our knowledge, the results show for the first time an overexpression of ISG15 in up to 80% of oral squamous cell carcinoma tissues collected from Indian patients. Hence ISG15 may be explored for the possibility of use as a high confidence diagnostic biomarker in oral cancers.

Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation

  • Eun, Sang-Soo;Chang, Won-Sok;Bae, Sang-Jin;Lee, Sang-Ho;Lee, Dong-Yeob
    • Journal of Korean Neurosurgical Society
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    • 제48권5호
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    • pp.419-422
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    • 2010
  • Objective : To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective neve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods : The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results : The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion : CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예 (A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure)

  • 오기원;박상규;김준성
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제12권2호
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    • pp.226-229
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    • 2009
  • 저자들은 하지의 자반과 함께 발생한 복통, 혈변, 구토, 핍뇨 등을 주소로 내원한 7세 소아에서 급성 췌장염과 저혈량성 급성 신부전이 함께 동반된 Henoch-Sch$\"{o}$nlein 자반증으로 진단하고 치료한 증례를 경험하였기에 문헌고찰과 함께 보고한다. 급성 췌장염은 Henoch-Schonlein 자반증 환자에서 매우 드문 합병증이지만 불필요한 개복술을 피하기 위하여 급성 복증의 다른 원인들과 반드시 감별 진단해야 한다.

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Identification of Enterococcus faecalis antigens specifically expressed in vivo

  • Lee, Seok-Woo;Shet, Uttom K.;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-Dug;Kang, Seong Soo;Kim, Se Eun
    • Restorative Dentistry and Endodontics
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    • 제40권4호
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    • pp.306-313
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    • 2015
  • Objectives: Molecular mechanism of the pathogenicity of Enterococcus faecalis (E. faecalis), a suspected endodontic pathogen, has not yet been adequately elucidated due to limited information on its virulence factors. Here we report the identification of in vivo expressed antigens of E. faecalis by using a novel immunoscreening technique called change-mediated antigen technology (CMAT) and an experimental animal model of endodontic infection. Materials and Methods: Among 4,500 E. coli recombinant clones screened, 19 positive clones reacted reproducibly with hyperimmune sera obtained from rabbits immunized with E. faecalis cells isolated from an experimental endodontic infection. DNA sequences from 16 of these in vivo-induced (IVI) genes were determined. Results: Identified protein antigens of E. faecalis included enzymes involved in housekeeping functions, copper resistance protein, putative outer membrane proteins, and proteins of unknown function. Conclusions: In vivo expressed antigens of E. faecalis could be identified by using a novel immune-screening technique CMAT and an experimental animal model of endodontic infection. Detailed analysis of these IVI genes will lead to a better understanding of the molecular mechanisms involved in the endodontic infection of E. faecalis.

Successful pleurodesis with OK-432 in preterm infants with persistent pleural effusion

  • Kim, Jeong-Eun;Lee, Chul;Park, Kook-In;Park, Min-Soo;NamGung, Ran;Park, In-Kyu
    • Clinical and Experimental Pediatrics
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    • 제55권5호
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    • pp.177-180
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    • 2012
  • OK-432 (picibanil) is an inactivated preparation of $Streptococcus$ pyogenes that causes pleurodesis by inducing a strong inflammatory response. Intrapleural instillation of OK-432 has recently been used to successfully treat neonatal and fetal chylothorax. Here we report a trial of intrapleural instillation of OK-432 in two preterm infants who were born with hydrops fetalis and massive bilateral pleural effusion. Both cases showed persistent pleural effusion, refractory to conservative treatment, up to postnatal days 26 and 46, respectively. An average of 80 to 140 mL of pleural fluid was drained daily. In case 1, the infant was treated with OK-432 during the fetal period at gestation 28 weeks and 4 days of gestation, but showed recurrence of pleural effusion and progressed into hydrops. Within two to three days after OK-432 injection, the amount of pleural fluid drainage was dramatically decreased and there was no reaccumulation. We did not observe any side effects related to OK-432 injection. We suggest that OK-432 should be considered as a therapeutic option in infants who have persistent pleural effusion for more than four weeks, with the expectation of the early removal of the chest tube and a good outcome.

압박성 신경병증 (Compression Neuropathy)

  • 김병성
    • 대한정형외과 초음파학회지
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    • 제1권2호
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    • pp.128-133
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    • 2008
  • 신경 압박의 원인은 외부로부터 가해지는 것도 있고, 신체 내부 병리가 발생하여 신경 주행에 따라 발생할 수 있다. 주관절 이하부에서 압박성 신경병증으로 정중 신경, 척골 신경, 요골신경병증이 있다. 정중 신경은 굴곡 지대부위에서 수근관 증후군이 대표적이며, 모든 신경 포착 증후군 가운데 가장 흔하다. 그 외 주관절 부위에서 스트러더스 인대, 상완 이두근 건막, 회내근, 천수지 굴근 기시부 그리고 비정상 근육들에 의한 회내근 증후군과 전 골간 신경 증후군이 있다. 척골 신경은 스트러더스 궁, 내측 상과 후방의 주관, 척수근 굴근 두 기시부 사이의 건막 등에서 눌리는 주관 증후군과, 수근부에서 결절종, 유구골 갈고리 골절 그리고 혈관성으로 오는 척골 관 증후군이 있다. 요골 신경의 심부 분지가 회외근속을 지나면서 만들어지는 부위에서 눌리는 경우 요골 관 증후군이라고 한다. 치료는 초기에는 소염제나 야간부목, 스테로이드 주사와 같은 보존적 치료를 시행할 수 있으며, 이에 호전되지 않을 경우 전기적 검사나 영상 검사에서 이상이 나타나면 수술적 감압술을 시행하여야 한다.

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자궁내막증 치료 전후 환자의 혈청이 생쥐 난자의 수정률에 미치는 영향 (The Effect of Serum Obtained before and after Treatment for Endometriosis on in vitro Fertilization Rate of Mouse Oocyte)

  • 김기석;민부기;이희섭;홍기연;이선영;박현진;김흥곤
    • Clinical and Experimental Reproductive Medicine
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    • 제26권3호
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    • pp.369-375
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    • 1999
  • Objective: To evaluate the effect of serum obtained before and after treatment for endometriosis on in vitro fertilization and development of two cell mouse embryo. Design: Pretreatment and posttreatment comparoson of fertilization of mouse oocyte and embryo development in serum supplement from patients with endometriosis; result were compared using Stuent T-test analysis. Method: Infertility Clinic, Department of Obstetrics and Gynecology, Collage of Medicine, Won kwang university, Korea. Patients was chosed eleven consecutive women with endometriosis. Interventions was all patient underwent laparoscopic or conservative surgery. This was followed by a 6-month course of burserelin acetate $900{\mu}g/d$. Main outcome was measured total number of fertilization and embryo that was fertilization after 24 hours and reached blastocyst stage after 72 hours of incubation were compared before and after treatment. Result: Before treatment, 47% of the oocyte were fertilized and 31% of the embryo reached blastocyst stage. After treatment, Significantly more fertilized and Significantly more embryo developed to blastocyst on the stage I and II of endometriosis. Conclusion: The fertilization and embryo toxicity of serum samples from patients with endometriosis is lost after treatment.

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