• 제목/요약/키워드: Obliteration

검색결과 169건 처리시간 0.027초

뇌동정맥기형 26예의 선형가속기를 이용한 뇌정위다방향 단일방사선치료 (Stereotactic Radiosurgery of 26 Intracranial Arteriovenous Malformations with Linear Accelerator)

  • 윤세철;서태석;장홍석;최규호;김문찬;신경섭;박용휘
    • Radiation Oncology Journal
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    • 제10권1호
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    • pp.21-26
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    • 1992
  • 가톨릭의대 강남성모병원 치료방사선과에서는 1988년 7월부터 1991년 11월 사이 40개월 동안에 26명의 수술 불가능한 뇌동정맥기형 환자에 대하여 6 MV선형가속기를 이용하여 뇌정위다방향 단일 방사선치료를 실시하였다. 환자연령은 6세부터 63세였고(중앙값 29세), 남녀의 비는 21:5였다. 치료 종료 후 추적기간은 4개월$\~$40개월 간이었다(중앙값 15개월). 뇌동정맥기형의 크기는 직경 1 cm부터 $43cm^3$까지였으며 환자 연영, 병소의 크기 및 뇌내 위치에 따라 4$\~$7회의 부분회전 조사를 실시하여 15$\~$30 Gy를 단일 조사하였다. 모든 환자는 임상적 그리고 CT또는 MRI나 뇌혈관조영술을 병행하여 방사선치료 전 및 후 6개월간격으로 뇌동정맥기형의 크기변화를 추적 분석하였다. 2년 이상된 예의 추적 검사를 분석한 결과 완전 관해 6($23\%$), 부분관해 8($31\%$), 무변화 1($4\%$)명 씩으로 분석되었다. 11($42\%$)명은 방사선치료한지 1년 미만의 무반응군으로 간주되었다. 이상으로 치료후 2년째 반응율은 $54\%$(14예)였다. 치료에 따른 부작용은 아직 관찰되지 않았다.

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근관협착된 치근파절 치아에서 의도적 재식술 치험례 (Intentional Replantation of a Root-Fractured Tooth with Pulp Canal Obliteration)

  • 김미희;이상호;이난영
    • 대한소아치과학회지
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    • 제43권2호
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    • pp.200-206
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    • 2016
  • 상아질, 백악질, 치수를 포함하는 파절로 정의되는 치근파절은 영구치에서 발생하는 외상 중 0.5-7%를 차지하며, 대부분 11-20세군의 상악 전치부에 호발한다. 영구치 치근파절의 처치는 기본적으로 변위된 치관부 파절편을 정복시키고 고정하는 것이다. 60-80%는 치수생활력이 유지되나 치수괴사나 염증성 치근흡수의 징후가 나타난다면 근관치료를 시행하게 되며 대부분에서 치근부 파절편의 치수생활력은 유지되기 때문에 근관치료는 치관부 파절편에 한하여 수행한다. 그러나 치관부 파절편에서 적절한 apical stop을 얻는 것은 어렵다. 의도적 재식술이란 통제된 환경에서 의도적으로 치아를 발거한 후 구강 외에서 치근단 치료를 시행하고 재식립하는 방법으로 완벽한 근관치료와 수복을 목표로 한다. 통상적인 근관치료가 실패한 경우, 기존의 수복물이 존재하거나 석회화된 근관으로 인해 재근관치료가 어려운 경우, 공간적으로 접근이 불가능하여 치근단 수술을 시행하지 못하는 증례에서 의도적 재식술이 계획될 수 있다. 본 증례에서는 이전의 외상으로 인해 석회화된 근관을 보이는 상악 중절치에서 발생한 수평 치근파절을 치료하기 위해 의도적 재식술을 이용하였고 임상적, 기능적으로 만족할만한 결과를 얻었기에 이를 보고하는 바이다.

상아질 형성부전증에 대한 증례 보고 (A CASE REPORT OF DENTINOGENESIS IMPERFECTA)

  • 전은민;김은정;김현정;김영진;남순현
    • 대한소아치과학회지
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    • 제33권2호
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    • pp.323-328
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    • 2006
  • 상아질 형성부전증은 상아질 형성 이상이 초래되는 유전성 질환으로, 주로 상염색체 우성으로 유전된다. 8000명당 1명꼴로 발생하며 남녀 성별의 차이가 없고 유치열과 영구치열 모두에서 나타난다고 알려져 있으며, Shield등은 세 가지 유형으로 분류하였다. 이환 받은 치 아는 다양한 치아 변색, 법랑질의 박리, 급속도의 상아질의 파괴, 심한 마모현상 등의 임상소견을 보인다. 따라서 치간이개, 고경감소, 저작능력의 저하, 치태와 치석의 침착 등이 나타날 수 있다. 방사선학적 소견으로 치경부 수축 구근 상치관, 짧고 가는 치근, 치수강과 근관의 폐색, 건전치 에서 치근부 병변 등이 보인다. 상아질 형성부전증에 대한 치료 목표는 심미성 회복, 저작능력회복, 교합고경의 회복을 들 수 있다. 본 증례들은 치아의 마모와 변색을 주소로 경북대학병원 소아치과에 내원한 두 명의 환아들에서 임상 및 방사선학적 검사 소견상 상아질 형성 부전증으로 판단되어 환아의 손상된 치아에 대해 치료를 시행하여 기능적 심미적으로 만족할 만한 결과를 얻어 이를 보고하는 바이다.

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농흉의 임상적 고찰[176예] (The Clinical Study for Empyema: 176 Cases)

  • 오봉석;최종범;이동준
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.475-485
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    • 1980
  • For the past 5 year 6 months from January 1975 to June 1980, 176 patients with empyema have been treated in Chonnam University Hospital. They were 134 males and 42 females ranging from ] 8 days to 69 years of age. [mean age: 26.1 years] The duration of illness prior to treatment was relatively shorter in pediatric group than in adult group, that is, the duration of less than 1 month was 89.5% in pediatric group and 38.0% in adult group. In bacteria study there were Staphylococcus 26.1%, Streptococcus 17.6%, E. coil 10.8%, Pseudomonas 10.8%, Diplococcus pneumoniae 5.7% and Candidia. And 4 children and 3 adults had infections of two species of bacteria. The underlying pathologic lesions were pyogenic pneumonia 34.7%, tuberculosis 29.5%, paragonimiasis 15.3%, trauma 9.7% and postoperative state. The over-all mortality rate was 1.7% [3 patients]. The causes of death were sepsis In 1 child and sepsis secondary to esophageal fistula in 2 adults. Adequate drainage and obliteration of the pleural space seems to be the most important aspect of treatment and can frequently be achieved by initial tube drainage in acute empyema, especially in the pediatric group. The chronic thick walled or loculated cavities required open window therapy, decortication, resection therapy and sterilization. Modified Eloesser`s operation and 0.3-0.5% potadine irrigation brought good result in the patients who had general weakness, marked pulmonary parenchymal destruction due to pyothorax, and pyothorax with severe bronchopleural fistula.

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Dentinogenesis imperfecta type II: A case report with 17 years of follow-up

  • Gama, Francisco Jose Reis;Correa, Isabella Sousa;Valerio, Claudia Scigliano;Ferreira, Emanuelle de Fatima;Manzi, Flavio Ricardo
    • Imaging Science in Dentistry
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    • 제47권2호
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    • pp.129-133
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    • 2017
  • Dentinogenesis imperfecta is a dominant autosomal hereditary disorder of dentin formation that affects the deciduous and permanent teeth. Its etiology is characterized by inadequate cell differentiation during odontogenesis. The clinical characteristics of dentinogenesis imperfecta are discolored teeth with a translucency that varies from gray to brown or amber. Radiographically, the teeth exhibit pulp obliteration, thin and short roots, bell-shaped crowns, and periapical bone rarefaction. The aim of this report was to present a case of dentinogenesis imperfecta type II that was followed up over a 17-year period. This report also presents scanning electron microscopy images of the enamel and dentin, showing that both were altered in the affected teeth. The disease characteristics and the treatments that were administered are reported in this study to guide dentists with respect to the need for early diagnosis and adequate follow-up to avoid major sequelae.

고식적 목적 혹은 Fontan 수술 전단계로서 시행한 양방향성 상공정맥 폐동맥 단락술의 조기 임상 결과 (Bidirectional Cavopulmonary Shunt Operations as Palliation or Pre-Fontan Stage Operation - Early Results -)

  • 한재진
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.406-411
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    • 1992
  • Thirty-four patients were received bidirectional cavopulmonary shunt[BCPS] from Aug. 1989 to Apr. 1991 at Sejong General Hospital, Puchon, Korea. Their ages were from 43 days to 21 years old with 19 cases of infant, 10 from 1 to 5 years old and 5 cases above 6 years old. Their diagnoses were as follows: 13 cases with uni-ventricular heart, 9 tricuspid atresia, 6 double outlet of right ventricle, 4 pulmonary atresia with intact ventricular septum, and 2 transposition of great arteries with pulmonary stenosis. Among them, 10 patients had received other palliative operations before. The BCPS operations were performed under the cardiopulmonary bypass and 10 patients who had bilateral superior vena cava received bilateral BCPS. Other associated procedures were 9 cases of takedown of Blalock-Taussig shunt, 3 pulmonary artery angioplasty, 1 unifocalization, 1 repair of total anomalous pulmonary venous return, 1 Damus procedure, 1 relief of sub-aortic stenosis, 1 right ventricular outflow tract reconstruction and one case of tricuspid valve obliteration. There were 3 operative deaths[8.8%] and two late deaths. The remainders show good postoperative state and their oxygen saturation was increased significantly. Conclusively, the bidirectional cavopulmonary shunt is very effective and safe palliative or pre-Fontan stage operation for the many complex congenital anomalies with low pulmonary blood flow especially for the patients who have the risk of Fontan repair.

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발생 부위에 따른 단순성 골낭종의 치료방법에 대한 연구 (The Treatment's Modality of Simple Bone cyst According to the Location)

  • 이석현;서승우;정현일
    • 대한골관절종양학회지
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    • 제2권1호
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    • pp.65-71
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    • 1996
  • Twenty-nine cases of unicameral bone cyst developed in long bone of children have been treated and followed up for 4.5 years in average form Department of Orthopaedic Surgery, Guro Hospital, Korea University, College of Medicine since September, 1983, Treatment for those lesions differed to form largely two groups, one of which consised of insillation of Methyl-prednisolone for non-weight bearing bones(12 humeri) and the other of curettage and autogenous bone graft for weight-bearing bones(7 femur). Methl-prednisolone group required repetition of instillation for 3.5 time in average spanning over 4 years until cloudy obliteration occurs. Curettage and bone graft had healed in 3 year 6 months' time in average. There were neither recurrence nor pathologic fractures of the lesions with the latter group. Immobilization period was virtually non with Methyl-prednisolone group and 4-6 weeks by hip spica with curettage and bone graft group. As conclusions, It seems confirmed that treatment strategy of unicameral bone cyst consisted of Methyl-prednisolone instillation for humerus lesions and early curettage and bone graft for femur lesions is applicable as guideline having solid ground in clinical experiences.

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불완전하게 결찰된 뇌동맥류의 혈관내치료 - 증 례 보 고 - (Endovascular Treatment of Incompletely Clipped Cerebral Aneurysm - Case Report -)

  • 임동준;정용구;조태형;이훈갑;김세훈;김근회;권택현;정흥섭;박정율;박윤관;이기찬;서중근
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.533-536
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    • 2001
  • Residual aneurysm is a challenging problem after clipping procedure for the aneurysms. The anthors describe one patient in whom endovascular treatment was sucessfully done to treat residual aneurysm after surgical clipping. We discussed the role of endovascular coil occlusion in case of incomplete surgical obliteration of aneurysms.

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Paradoxical Exacerbation of Symptoms with Obstruction of the Venous Outflow after Gamma Knife Radiosurgery for Treatment of a Dural Arteriovenous Fistula of the Cavernous Sinus

  • Ko, Jun Kyeung;Cho, Won Ho;Lee, Tae Hong;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • 제57권2호
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    • pp.127-130
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    • 2015
  • A 59-year-old female presented with progressive right proptosis, chemosis and ocular pain. An imaging work-up including conventional catheter angiography showed a right-sided dural arteriovenous fistula of the cavernous sinus, which drained into the right superior petrosal sinus, right superior ophthalmic vein, and right inferior ophthalmic vein, and cortical venous reflux was seen via the right petrosal vein in the right posterior fossa. After failure of transvenous embolization, the patient underwent Gamma Knife radiosurgery (GKRS). At one month after GKRS, she developed increasing ocular pain and occipital headache. Repeat angiography showed partial obliteration of the fistula and loss of drainage via the superior and inferior ophthalmic veins with severe congestion, resulting in slow flow around the right cerebellar hemisphere. Prompt transarterial embolization relieved the patient's ocular symptoms and headache. We report on a case of paradoxical exacerbation of symptoms resulting from obstruction of the venous outflow after GKRS for treatment of a dural arteriovenous fistula of the cavernous sinus.

Bilateral Vertebral Artery Dissecting Aneurysms Presenting with Subarachnoid Hemorrhage Treated by Staged Coil Trapping and Covered Stents Graft

  • Yoon, Seok-Mann;Shim, Jai-Joon;Kim, Sung-Ho;Chang, Jae-Chil
    • Journal of Korean Neurosurgical Society
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    • 제51권3호
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    • pp.155-159
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    • 2012
  • The treatment of bilateral vertebral artery dissecting aneurysms (VADAs) presenting with subarachnoid hemorrhage (SAH) is still challenging. The authors report a rare case of bilateral VADA treated with coil trapping of ruptured VADA and covered stents implantation after multiple unsuccessful stent assisted coiling of the contralateral unruptured VADA. A 44-year-old woman was admitted to our hospital because of severe headache and sudden stuporous consciousness. Brain CT showed thick SAH and intraventricular hemorrhage. Cerebral angiography demonstrated bilateral VADA. Based on the SAH pattern and aneurysm configurations, the right VADA was considered ruptured. This was trapped with endovascular coils without difficulty. One month later, the contralateral unruptured VADA was protected using a stent-within-a-stent technique, but marked enlargement of the left VADA was detected by 8-months follow-up angiography. Subsequently two times coil packing for pseudosacs resulted in near complete occlusion of left VADA. However, it continued to grow. Covered stents graft below the posterior inferior cerebellar artery (PICA) origin and a coronary stent implantation across the origin of the PICA resulted in near complete obliteration of the VADA. Covered stent graft can be used as a last therapeutic option for the management of VADA, which requires absolute preservation of VA flow.