• 제목/요약/키워드: In=Mercy

검색결과 108건 처리시간 0.018초

Penetrating gallbladder injury in a pediatric patient in the United States: a case report

  • Nelimar Cruz-Centeno;Shai Stewart;Derek R. Marlor;Charlene Dekonenko;Richard J. Hendrickson
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.295-297
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    • 2023
  • Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient's hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.

안와첨부 이물 육아종의 치험례 (Clinical Experience of Foreign Body Granuloma in the Apex of Orbit)

  • 백혜원;최종우;정현권;이백권;안상태
    • Archives of Plastic Surgery
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    • 제32권1호
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    • pp.131-134
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    • 2005
  • It is often difficult to identify and localize intraorbital foreign bodies despite of modern high-resolution imaging investigation. Especially, posteriorly located foreign bodies have increased risks of morbidity that surgical approach is often complicated. No matter how trivial it seems, retained foreign body, particularly organic in nature, may give rise to severe orbital and cerebral complications. High clinical suspicion, proper diagnostic studies, timely referral to a skilled orbital surgeon are mandatory. We report a case of intraorbital wooden foreign body that required two separate exploration for removal. Initial exploration failed to identify and locate the foreign body completely. After the operation, fistula formation and purulent discharge were developed and the imaging investigation results were equivocal, complicating the management. A second exploration yielded multiple intraorbital wooden foreign body in the apex of orbit. The patient fully recovered without complication. The evaluations and the details of management strategy are discussed.

Surgical Treatments for Cervical Spondylotic Myelopathy Associated with Athetoid Cerebral Palsy

  • Lee, Yong-Jeon;Chung, Dong-Sup;Kim, Jong-Tae;Bong, Ho-Jin;Han, Young-Min;Park, Young-Sup
    • Journal of Korean Neurosurgical Society
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    • 제43권6호
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    • pp.294-299
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    • 2008
  • Objective : To evaluate the clinical characteristics and surgical outcomes of the patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy. Methods : The authors reviewed the clinical and neurodiagnostic findings, surgical managements and outcomes in six consecutive patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy who had been treated with surgical decompression and fusion procedures between January 1999 and December 2005. The mean age of the 6 patients (four women and two men) at the time of surgery was 42.8 years (range, 31-55 years). The mean follow-up period was 56.5 months (range, 17-112 months). The neurological outcome was evaluated before and after operations (immediately, 6 months after and final follow-up) using grading systems of the walking ability, brachialgia and deltoid power. Results : At immediate postoperative period, after 6 months, and at final follow-up, all patients showed apparent clinical improvements in walking ability, upper extremity pain and deltoid muscle strength. Late neurological deterioration was not seen during follow-up periods. There were no serious complications related to surgery. Conclusion : Surgical decompression and stabilization in patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy have been challenging procedure up to now. Our results indicate that early diagnosis and appropriate surgical procedure can effectively improve the clinical symptoms and neurological function in patients with cervical spondylotic myelopathy and athetoid cerebral palsy, even in those with severe involuntary movements.

A Case of Astroblastoma

  • Han, Young-Min;Kim, Jong-Tae;Chung, Dong-Sup;Park, Young-Sup
    • Journal of Korean Neurosurgical Society
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    • 제40권5호
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    • pp.373-376
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    • 2006
  • An astroblastoma is a rare primary glial tumor occurring preferentially in young adults. It is characterized by a perivascular arrangement of the tumor cells forming perivascular pseudorosettes mimicking ependymomas. The histogenesis of astroblastoma is unclear, despite a number of studies to determine its possible cellular origin. We have experienced a case of astroblastoma located at the temporal lobe. It presented as a large, well-circumscribed, and highly enhanced mass lesion on magnetic resonance images[MRI]. The tumor was well demarcated and did not infiltrate the brain, which made complete removal possible. Here, we report and discuss the characteristic histological and radiological features of this case.

Sacral Insufficiency Fracture, Usually Overlooked Cause of Lumbosacral Pain

  • Lee, Yong-Jeon;Bong, Ho-Jin;Kim, Jong-Tae;Chung, Dong-Sup
    • Journal of Korean Neurosurgical Society
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    • 제44권3호
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    • pp.166-169
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    • 2008
  • Sacral insufficiency fractures are usually known to develop in elderly patients with osteoporosis without definite trauma history. It is difficult to diagnose the sacral insufficiency fracture at an early stage because lower lumbar diseases. concurrently or not, may also be presented with similar symptoms and signs. We report a rare case of sacral insufficiency fracture who was not diagnosed initially but, instead, showed progressively worsening of clinical symptoms and radiological findings after decompression surgery for upper level lumbar stenosis.

성대에 발생환 혈관종 1예 (A Case of Vocal Cord Hemangioma)

  • 전은주;박용수;이승균;김동기
    • 대한후두음성언어의학회지
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    • 제15권1호
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    • pp.52-54
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    • 2004
  • Hemangioma of the larynx is generally classified into adult and infantile form. More common infantile form usually arises on subglottic portiion and may cause respiratory distress. Adult form is rare and arises on vocal cord or above. Vocal cord hemangioma was rarely reported in the medical literature. Since Kimmelman et al reported vocal hemangioma in 1979 first, there are four cases of vocal hemangioma reported in medical literature. Recently, we experienced a case of vocal cord hemangioma and successfully removed it with micro-laryngeal surgery. Hence we report this case with review of literatures.

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위암 수술 환자에서의 삶의 질 (Quality of Life in Patients with Stomach Cancer after Operation)

  • 전양환;한상익;전철은;김진조;박승만
    • Journal of Gastric Cancer
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    • 제4권1호
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    • pp.27-31
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    • 2004
  • Purpose: This study was designed to explore quality of life (QOL) in patients with stomach cancer by using the World Health Organization Quality of Life (WHOQOL) Instrument- Korean version. Materials and Methods: Thirty-one (31) patients with stomach cancer after curative resection were recruited with informed consent. Age- and gender-matched hospital staff served as controls. The 100-item WHOQOL Instrument, including physical domain, psychological domain, social domain, independence domain, environment domain, and spiritual domain, was employed for the all subjects. Results: In patients with stomach cancer after operation, only two domains, physical and independence, were associated with worse quality of life. In those domains, patients with advanced stage, with total gastrectomy, with adjuvant chemotherapy, and early or late postoperative period ($\leqq$2 years or >5 years after operation), could be perceived of having a worse quality of life. Conclusion: Not only scientific objective success but also individual subjective perception of condition could be important for managing patients with stomach carcinomas after curative resection. In this context, the WHOQOL reflecting multi-dimensional state of well being could be a useful tool across a variety of cultural and value systems in the world.

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단일 분절 퇴행성 경추질환에서 Titanium Cage를 이용한 전방 융합술의 조기 치험 : 골편 이식을 동반하지 않은 경우의 임상적 방사선학적 초기 결과 (Preliminary Experience with Cervical Implantable Titanium Cage(RABEA) in Patients with Monosegmental Degenerative Disease : Clinical and Radiological Outcomes without Cancellous Bone Filling into Cage)

  • 이영균;한영민;김종태;정동섭;박영섭;박춘근;강준기
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.300-308
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    • 2001
  • Objectives : Anterior cervical discectomy and interbody fusion has become a well-accepted surgical treatment of degenerative cervical diseases. Implatable cages have a stabilizing effect without plates and no need for autogenous bone graft. The authors evaluates the effect of implatable titanium cage(RABEA) on the clinical and radiological outcomes. Methods : 34 patients with symptomatic cervical degenerative diseases due to one level disc pathology were underwent anterior cervical discectomy and interbody fusion with titanium cages(RABEA) which were not filled with cancallous bone grafts from January 1999 to May 2001. Patients with osteoporosis and older than 65 years were not included. Among them, 15 patients could be followed-up for at least 1 year. The authors retrospectively reviewed the charts and radiographic data. Mean follow-up period was $1.3{\pm}0.2years$. Results : Clinical results according to the Odom's criteria was exellent and good in 14(93%) patients. One patient with fair result showed complete loss of the disc space height due to settlement of the cage. Preoperatively, the mean height of the disc space(${\pm}$standard deviation) was $3.42{\pm}1.10mm$(range 2.0-5.5mm), and at 1 day postoperatively it was $7.88{\pm}0.90mm$(range 6.50-9.0). The mean height of the disc space after 1 year was $6.50{\pm}1.38mm$(range 3.0-8.0). The restoration of the height was statistically significant(p<0.05). The mean height after 1 year was $82.7{\pm}15.9%$ of the height at 1 day postoperatively. Preoperatively the mean value of the cervical lodortic angle was $21.8{\pm}11.8^{\circ}$ and 1 year postopertively, it was $24.5{\pm}8.3^{\circ}$, which was statistically not significant. All patients showed no abnormal movements on flexion and extension lateral film after 6 months. Conclusion : Implantable titanium cages appear safe and effective in selected patients, and their use helps to avoid complications associated with bone graft harvest. Subsidence of the cage seems to be a potential risk factor for recurrence of the symptoms. For long-term results, a longer follow-up is required.

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이중 내측 활막추벽 증후군 - 1예 보고 - (Double Medial Plica Syndrome - Case Report -)

  • 손종민;장주해;하난경;조성태;황정택
    • 대한관절경학회지
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    • 제10권1호
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    • pp.108-111
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    • 2006
  • 저자들은 우 슬관절에 발생한 이중 내측 활막추벽 증후군 환자를 경험하였기에 보고한다. 일반적으로 활막추벽 증후군은 전형적인 증상이나 통증이 없을수 있으며, 다양한 골관절 증상을 유발하는 다른 슬내장증의 원인들과 감별진단이 요구된다. 결정적인 진단에는 MRI와 관절경술이 필요하며, 증상이 있는 경우 관절경적 제거술에 의해 증상의 호전이 이루어진다고 보고된다. 본 환자는 앉거나 계단을 오를 때, 우 슬관절 동통을 호소하였고, MRI상 전형적인 이중 내측 활막추벽이 관찰되어 관절경적 절제술을 시행하였다. 술후 환자는 만족스러운 임상호전을 보였다.

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