• 제목/요약/키워드: One-incision

검색결과 345건 처리시간 0.023초

관절경하 유관 나사를 이용한 족관절 관절 고정술 (3례 보고) (TAnkle Arthrodesis Using Cannulated Screws under Arthroscopy -Three cases report-)

  • 김명구
    • 대한관절경학회지
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    • 제2권1호
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    • pp.59-63
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    • 1998
  • There have been numerous methods to obtain a stable arthrodesis of the tibiotalar joint. However, a controvercy has arisen over the most successful and reproducible method to obtain an arthrodesis. The objective of this report is to show that an ankle arthrodesis can be performed successfully and advantageously by using cannulated screws under arthroscopic control and that our csaes will be a part of the multicentric study of arthroscopic ankle arthrodesis in korea. Between May 1996 and May 1997, we perfomed 3 ankle arthrodesis under arthroscopy using cannulated screws. Two patients had post-traumatic osteoarthritis and one had rheumatoid arthritis. Clinical ankylosis in one case and radiological union in two cases were obtained in 12 weeks postoperatively. We propose that arthroscopic ankle arthrodesis is effective procedure in patient who has minimal deformity and bone loss, advantages like small incision, minimal morbidity, low infection rate and rapid return to normal daily activity, but more cases and comparision with open tecnique will be needed.

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영상유도 뇌수술 장비의 임상적 적용 : Zeiss SMN System (Clinical Application of Image Guided Surgery : Zeiss SMN System)

  • 이채혁;이호연;황충진
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.72-77
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    • 2000
  • The authors describe the experience with the interactive image-guided Zeiss SMN system, which has been applied to 20 patients with various intracranial lesions during one year. Preoperative radiologic evaluation was CT scan in 6 cases, MRI in 14 cases. In all except one case, average fiducial registration errors were less than 2mm. There was no statistical difference in registration error between CT and MR image. This system considered to be relatively stable with respect to soft and hardware. Also it was useful for the designing of the scalp incision and bone flap and assessing the extent of resection in tumors, especially in gliomas. Moreover, it was helpful to evaluate complex surgical anatomy in skull base surgery.

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흉강경을 이용한 기흉의 치료 (Thoracoscopic Treatment of Spontaneous Pneumothorax)

  • 김광호
    • Journal of Chest Surgery
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    • 제24권3호
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    • pp.261-264
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    • 1991
  • The result of thoracotomy for recurrent and persistent pneumothorax is usually excellent. However the patients undergone thoracotomy suffer from postoperative chest pain and require long postoperative recovery period. Also the operative incision scar gives the patients cosmetic problems. Subpleural blebs are usually causes of pneumothorax. They can be reached through the thoracoscope without thoracotomy and can be ablated by electrical cautery through it. Six patients with recurrent and persistent pneumothorax were managed thoracoscopic-ally. Five patients were successful and one case was failed. The failed case was explored 21 days after thoracoscopy. Follow-up period was from one to eight months. Although the follow-up period was short, thoracoscopic management of recurrent and persistent pneumothorax is thought to be good for preventing thoracotomy.

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근육편에 의한 정중 흉골절개 감염의 치료 -5례 치험- (Management of Infected Median Sternotomy Wound by Muscle Flap -5 cases-)

  • 김형곤;조선환;최종범
    • Journal of Chest Surgery
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    • 제27권7호
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    • pp.634-638
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    • 1994
  • Infection of a median sternotomy incision may result in a large, unsightly,unstable,and potentially fatal wound. During the past 8 years, 5 consecutive patients [ 4 male and 1 female ] had repair of infected sternotomy wound. We describe our current preferred techniques and the results we have achieved with them. As soon as the sternal infection was shown, operative wound was opened and irrigated more than 4 times a day with 0.5% Betadine iodine solution until the exudate became clean with no growth of bacteria. Operation was performed in one-stage, which consisted of aggressive debridement of the infected bone and muscle transposition. Reconstruction was with one-side or both pectoralis flaps in all patients and rectus abdominis in 2 patients. There was no mortality or morbidity within 30 days postoperatively. We conclude that early aggressive debridement and muscle transposition remain the treatment of choice for most patients with infected median sternotomy wounds.

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Duromedics 승모판막의 판엽파손 (Duromedics Mitral Valve Leaflet Escape)

  • 나찬영
    • Journal of Chest Surgery
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    • 제25권7호
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    • pp.750-755
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    • 1992
  • We report a case of leaflet embolization of central leaflet fracture a 31mm mitral Edw-ards-Duromedics prosthesis. A leaflet was fractured to two segments, a larger one embolized to right common iliac artery and a smaller one to left femoral artery, respectively. Patient was reoperated with 29mm mitral Carbomedics prosthesis and incidentally found of smaller segment in left femoral artery at cannulation site. The embolectomy was done 15 days after cardiac operation through midline abdominal incision, Leaflet escape of a mitral Edward-Duromedics prosthesis is a rare, potentially curable mode of valve failure. After mechanical valve replacement, unexplained heart failure and acute pulmonary edema, mechanical valve failure should be suspected. Correct interpretation of clinical signs, symptoms and fluroscopy should allow early diagnosis of leaflet escape and prompt surgical therapy.

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경피적 폐생검술후 흉벽에 전이된 폐암;1례 보고 (Chest Wall Implantation of Lung Cancer after Percutaneous Fine Needle Aspiration - Report of one case -)

  • 원태희
    • Journal of Chest Surgery
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    • 제25권7호
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    • pp.707-710
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    • 1992
  • Percutaneous needle aspiration has been widely used in the diagnosis of pulmonary lesions, because it is a fairly simple procedure with good diagnostic accuracy and low complication rate. Among its complications, the spread of malignant cells along the needle tract is rare but serious one. We report a case of chest wall implantation of lung cancer after the percutaneous fine needle aspiration biopsy. A 57-year-old man had undergone a right upper lobectomy for squamous cell carcinoma [T2N0M0] of the lung, 3 months after the operation, a growing mass, located far from the previous thoracotomy incision, developed on the right anterior chest wall where the diagnostic thin needle biopsy had been performed before the lobectomy. A wide excision of the chest wall mass was performed, and permanent histology showed squamous cell carcinoma as noted before.

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한국(韓國)의 청동탑(靑銅塔)에 관한 연구(硏究) (A Study on the Korean Bronze Pagoda)

  • 천득염;지승용
    • 건축역사연구
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    • 제7권2호
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    • pp.29-48
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    • 1998
  • The first Pagoda of Korea was introduced from China, and adapted from the wooden multi-storied pavilion. Also in Bronze one, multi-storied type of wooden pagoda was adapted. Bronze pagoda was used to buddhist ossuary and a kind of metalwork. Metalworks were made of gold, silver, copper, or iron by one of the methods of production-casting or hammering and decorated design of incision, raise, openwork, gold- plating or inlaying with gold and silver. Sometimes it was used as the easy carriage of Buddha image by guess. In most cases, the plan of Bronze pagoda was square and podium was one story. but in the advance of podium two-storied platform appeared. Column appeared in a symbol, so it didn't appear in a square and circular form. It means that the column was vertical member which only divided the wall. In koryo period, Gabled roof and Half-hipped roof was spreaded in public but Bronze pagoda was used to square Hipped roof. Vertical shaft over roof(上輪部), apart from body of pagoda(塔身部), was inserted on the hole above the Bokbal(覆鉢) for the balance of pagoda. And a thick iron bar put in the roof to the platform. It was sustained the balance of pagoda. The stories of pagoda were various from 3rd stories to 9, the lower stories was larger scale and the higher was smaller one.

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가토 피부상처에서의 개방드레싱과 밀봉드레싱의 효과에 대한 형태학적 비교 (Morphological Comparision of the Effect of Open and Occlusive Dressing on Rabbit Skin Wound)

  • 강영희;홍해숙
    • Journal of Korean Biological Nursing Science
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    • 제5권1호
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    • pp.23-33
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    • 2003
  • 본 연구는 체중 3.0kg의 가토 수컷 10마리를 이용하여 피부의 외상을 입힌 후 개방드레싱과 밀봉드레싱이 상처의 치유과정에서의 효과와 형태학적 차이를 비교하기 위해 1cm의 절개창과 $1.0{\times}0.2cm$의 피부절제창을 만든 후 개방드레싱군은 1일 2회 betadine으로 소독한 후 상처부위를 노출시켜 5, 10 및 15일째에 관찰하였으며, 밀봉드레싱군은 매일 betadine으로 소독하고 1% silver sulfadiazine 크림을 도포한 후 거즈를 덮어 5, 10 및 15일째에 광학현미경으로 관찰하여 다음과 같은 결론을 얻었다. 피부를 절개한 군과 절제한 군을 개방드레싱 및 밀봉드레싱을 각각 시행한 5일 후에는 딱지가 형성되었고 표피의 재생은 상처의 가장자리에서부터 시작하였다. 진피의 표층에는 호중구, 단구 및 림프구의 침윤이 일어났고 부종과 섬유아세포의 증식이 경하게 일어났다. 수상 후 개방드레싱 및 밀봉드레싱을 시행한 10일 후에는 딱지는 탈락되었고 표피는 재생되어 연속적이었다. 모세혈관의 수와 염증세포의 침윤은 감소하였다. 부종과 섬유아세포의 증식은 더욱 증가하였다. 수상 후 개방 및 밀봉드레싱을 시행한 후 15일에는 표피의 재생은 완성되어 각질이 형성되었다. 진피에는 염증세포의 침윤, 부종 및 혈관의 증식은 소실되었고 섬유아세포 및 교원섬유의 양은 증가하였다. 피부를 절개한 군은 절제 군에 비해 반흔의 양은 적었고 드레싱방법에따른 치유과정의 차이는 없었다. 이상의 성적으로 보아 상처의 치료는 드레싱의 방법보다 상처의 소독이 중요한 역할을 하는 것으로 사료된다.

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$CO_2$ Laser와 Scalpel을 이용한 절개 시 돼지 자궁에서의 창상 치유 평가 (Comparative Study of Wound Healing in Porcine Uterus with $CO_2$ Laser and Scalpel Incisions)

  • 이재연;박창식;조성환;정성목;김명철
    • 한국임상수의학회지
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    • 제26권6호
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    • pp.563-567
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    • 2009
  • Steel scalpel과 $CO_2$ laser를 이용한 돼지 자궁 절개 시 창상 치유에 미치는 영향을 평가하고자 본 실험을 실시하였다. 다섯 마리의 Landrace - Yorkshire 혼혈 종 돼지를 이용하였고, 각각의 돼지에서 좌측 및 우측의 자궁에 대칭적으로 scalpel과 $CO_2$ laser를 이용하여 절개 하였다. 각각의 기구는 절개 속도, 절개의 용이성 및 출혈 정도를 평가 하였으며 수술 후 21일에 육안적인 유착 정도와 조직학적 검사를 실시하였다. Scalpel을 이용한 절개는 레이저를 이용한 절개보다 용이하였으나 두 군간의 유의성은 없었다. 레이저를 이용한 절개 시 출혈량은 적었으나 절개속도는 scalpel을 이용한 경우가 빨랐다. $CO_2$ laser 절개에서의 수술 후 자궁 유착은 scalpel 절개에서 보다 적게 발생하였다. 조직학적 검사에서 scalpel 절개의 경우 상피 조직과 자궁내막선의 재생이 완전히 이루어 졌으나 레이저를 이용한 경우 불완전한 재생 상태를 보였다. 비록 scalpel을 이용한 절개가 $CO_2$ laser를 이용한 경우 보다 조직 손상이 적었으며 사용하기 용이하였으나 출혈이 많은 단점이 있다. 반면 $CO_2$ laser를 이용한 절개의 경우 지혈 효과는 좋으나 창상 치유를 지연 시켰다.

개에서 내시경을 이용한 경위장관 담낭절제술 1예 : 자연개구부 내시경수술 (Transgastric Endoscopic Cholecystectomy in a Dog : Natural Orifice Transluminal Endoscopic Surgery)

  • 정성목;김영일;이재연;지현철;박지영;박종헌;김지연;이상일;김명철;신상태;이영원
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.315-319
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    • 2007
  • 1년령, 암컷, 15 kg의 잡종견에서 위내시경을 이용한 경위장관 담낭절제술을 최소한의 복강경 도움아래에서 성공적으로 수행하였다. 내시경용 바늘 절개도를 이용하여 배쪽 유문부에서 위절개를 실시하였다. 위절개부를 통하여 내시경을 복강내로 진입한 다음 뒤쪽으로 돌려서 담낭쪽 시야를 확보하였다. 술야의 확보를 위해 복강경용 겸자를 이용하여 담낭의 바닥부위를 부드럽게 들어올렸다. 담낭관과 동맥을 내시경용 endoclip을 이용하여 3중 결찰하였다. 담낭관과 동맥을 절단한 후 내시경용 소작겸자와 바늘 절개도를 이용하여 담낭을 간으로부터 분리하였다. 분리된 담낭은 내시경을 이용해 입을 통하여 제거하고, 위절개부위는 내시경용 endoclip을 이용하여 봉합하였다. 술후 3일째 방사선검사 및 혈청화학검사를 통해 위봉합부위의 천공이 없음과 담즙의 누출이 없음을 확인하였다. 술후 16일째 위내시경과 복강경 검사를 실시하였다. 위내시경검사 결과 봉합부위가 완전히 유합 되었음을 확인하였고 복강경 검사를 통해 담낭절제부위와 위절개부의 장막에 대망막이 유착되어있음을 확인하였다. 본 연구는 개에서 자연개구부 내시경수술(NOTES)을 이용한 담낭절제술의 최초 보고로써 새로운 방법에 의한 담낭절제술에 대한 가능성을 제시한다.