• 제목/요약/키워드: Proximal segment

검색결과 152건 처리시간 0.022초

Ruptured Aneurysm Arising from the Distal End of a Proximal A1 Fenestration : Case Report and Review of the Literature

  • Koh, Jun-Seok;Kim, Eui-Jong;Lee, Seung-Hwan;Bang, Jae-Seung
    • Journal of Korean Neurosurgical Society
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    • 제45권1호
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    • pp.43-45
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    • 2009
  • A 75-year-old female presented with subarachnoid hemorrhage. Angiography revealed a partial duplication (fenestration) in the proximal $A_1$ segment and a ruptured aneurysm at the distal end of $A_1$ fenestration. This congenital anomaly accompanying an aneurysm was associated with duplicated ipsilateral middle cerebral artery (MCA). Congenital defect of the arterial wall and hemodynamic factors at the fenestrated $A_1$ are considered to play a significant role in the development of this aneurysm. The present case is peculiar because not only the ruptured $A_1$ aneurysm was related with the anterior and middle cerebral artery duplication but also the location of $A_1$ fenestration and the origin of $A_1$ aneurysm in a fenestration are quite unusual.

Unilateral intraoral vertical ramus osteotomy and sagittal split ramus osteotomy for the treatment of asymmetric mandibles

  • Lee, Jee-Ho;Park, Tae-Jun;Jeon, Ju-Hong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권2호
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    • pp.102-108
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    • 2015
  • In surgery for facial asymmetry, mandibles can be classified into two types, rotational and translational, according to the required mandibular movements for surgery. During surgery for rotational mandibular asymmetry, a bilateral sagittal split ramus osteotomy (BSSRO) may cause a large bone gap between the proximal and distal segments as well as condylar displacement, resulting in a relapse of the temporomandibular joint disorder, especially in severe cases. The intraoral vertical ramus osteotomy has an advantage, in this respect, because it causes less rotational displacement of the proximal segment on the deviated side and even displaced or rotated condylar segments may return to their original physiologic position. Unilateral intraoral vertical ramus osteotomy (UIVRO) on the short side combined with contralateral SSRO was devised as an alternative technique to resolve the spatial problems caused by conventional SSRO in cases of severe rotational asymmetry. A series of three cases were treated with the previously suggested protocol and the follow-up period was analyzed. In serial cases, UIVRO combined with contralateral SSRO may avoid mediolateral flaring of the bone segments and condylar dislocation, and result in improved condition of the temporomandibular joint. UIVRO combined with contralateral SSRO is expected to be a useful technique for the treatment of rotational mandibular asymmetry.

Persistent Trigeminal Artery Detected by Conventional Angiography and Magnetic Resonance Angiography

  • Kim, Myoung-Soo;Hur, Jin-Woo;Lee, Jong-Won;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • 제37권2호
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    • pp.101-104
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    • 2005
  • Objective: A persistent trigeminal artery (PTA) may be found incidentally on conventional cerebral angiography and magnetic resonance(MR) angiography. Our goal is to examine the course and relationships of the vessel to the surrounding structures. Methods: Cerebral angiography was performed in 494 patients and MRA in 880; the patients had or were suspected to have cerebrovascular disease. In the images, the incidence, origin, course, and relationships of the PTA were evaluated. Results: A PTA was found in two (0.4%) of the patients undergoing cerebral angiography and three (0.34%) receiving an MR angiography. In four patients, the PTA arose from the lateral part of the cavernous segment of the internal carotid artery, then passed caudally and around the base of the dorsum sellae. In the other patient, the PTA arose from the medial aspect of the siphon, and ascended sharply to pierce the dorsum sellae and join the basilar artery. In four cases, there was hypoplasia of a proximal basilar artery below the abnormal communication; the vessel was of increased diameter above the communication. Conclusion: Identification of a PTA with a trans-sellar course is crucial if trans-sphenoidal surgery is planned. Hypoplasia of a proximal basilar artery should not be mistaken for an acquired narrowing.

태권도 돌려차기 동작의 운동학적 협응 및 제어과정 (The Process of the Kinematic Coordination and Control of Dollyochagi Motion in Taekwondo)

  • 윤창진;채원식
    • 한국운동역학회지
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    • 제18권2호
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    • pp.95-104
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    • 2008
  • 본 연구는 남자 중학교 초보피험자들을 대상으로 태권도 돌려차기 동작의 숙련정도에 따른 운동학적 협응과 제어과정을 살펴보는 데 목적을 두었다. 이용된 변인은 최대합성직선속도와 각도 대 각도 도면이었다. 분석결과, 연습후기로 갈수록 인접한 분절간의 운동량 전이가 잘 이루어져 각 분절의 최대합성직선속도가 증가하였으며 무릎관절 최대굴곡 시까지는 엉덩관절과 무릎관절이 동형동조 협응형태로 변해갔으며, 최대굴곡 후 타격 시까지는 모든 숙련 단계에 있어서 이형동조 협응패턴을 나타내었다. 발목관절은 무릎관절 최대굴곡 시까지 배측굴곡 상태에서 저측굴곡으로 변했으며, 최대굴곡 후 타격시점까지는 발목관절은 고정시키고, 무릎관절은 신전시키는 자유도 고정 제어기전을 나타내었다.

Bechet씨 병에 발생한 폐동맥류: 치험 1례 (Pulmonary Artery Aneurysm in Behcet`s Disease - Report of a Case -)

  • 김선한
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.412-417
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    • 1992
  • Pulmonary artery aneurysm is Behcet`s disease is rare and can be fatal due to rupture. We experienced a case of pulmonary artery aneurysm in Behcet`s disease. The patient was 21 year old woman who was adimitted with three month history of dyspnea, fever and cough. On examination, she had aphthous ulcer in the mouth and erythema nodosum on the left popletial fossa and forearm, but didn`t have any lesion at eyes and genitalia. The latex fixation test for rheumatoid factor, VDRL test for syphillis, antinuclear antibody and LE cell test were all negatives. The third and fourth components of complement in the serum, serum immunoglobulin concentrations[IgG, IgM, IgA] were within normal range. The chest radiography revealed a 5x6cm sized radiopaque mass density in the left hilar region. Two months later, the mass was enlarged to 6x7cm. The IV-DSA showed a single aneurysm at the proximal part of left lower lobe artery with lingular segment artery and no distal perfusion by thombotic obstruction. The steroid therapy was done for a month, but symptoms not improved. We performed resection of lingular segment and lower lobe including the aneurysm. The microscopic findings of the operative specimen were intimal hyperplasia and fragmentation of the internal elastic fibers. She was improved without remarkable event, except infection of the operative wound.

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Temporary Semi-Jailing Technique for Coil Embolization of Wide-Neck Aneurysm with Small Caliber Parent Artery Following Incomplete Clipping

  • Byun, Jun Soo;Kim, Jae Kyun;Lee, Hwa Yeon;Hwang, Sung Nam
    • Journal of Korean Neurosurgical Society
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    • 제53권4호
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    • pp.241-244
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    • 2013
  • The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior portion of wide-neck aneurysm remained. We decided to treat the remnant aneurysm using an endovascular modality. After selection of the aneurysm, coil packing was performed assisted by the temporary semi-jailing technique. The Enterprise stent (Cordis Neurovascular, Miami, FL, USA) was deployed and recaptured repeatedly for angiography to ensure safety of the small caliber parent artery. Successful semi-deployment and recapture of the stent allowed subtotal coil occlusion of the aneurysm with good anatomic and clinical results. No complications were encountered. The stent could be recaptured up to the point where the proximal end of the stent marker was aligned with distal marker band of the microcatheter, approximately 70% of the stent length. The temporary semi-jailing technique is feasible for wide-neck aneurysm with small caliber parent artery.

Tubular Colonic Duplication Presenting as Rectovestibular Fistula

  • Karkera, Parag J.;Bendre, Pradnya;D'souza, Flavia;Ramchandra, Mukunda;Nage, Amol;Palse, Nitin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권3호
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    • pp.197-201
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    • 2015
  • Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus.

Three-Dimensional Angiographic Demonstration of Plexiform Fenestrations of the Proximal Anterior Cerebral Artery Associated with a Ruptured Aneurysm

  • Koh, Jun-Seok;Lee, Seung-Hwan;Bang, Jae-Seung;Kim, Gook-Ki
    • Journal of Korean Neurosurgical Society
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    • 제44권5호
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    • pp.338-340
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    • 2008
  • A rare case of ruptured aneurysm associated with multiple $A_1$ fenestrations resembling plexiform network was demonstrated by 3D angiography. A 56-year-old female presented with a ruptured aneurysm in the $A_2$ segment of the left distal anterior cerebral artery associated with the right $A_1$ fenestration. The ruptured aneurysm was occluded with surgical neck clipping via interhemispheric approach without neurological deficit. Plexiform fenestrations of the right distal $A_1$. opposite side to the left ruptured $A_2$ aneurysm, were clearly visible on postoperative 3D angiography. Our case may strongly support the theory described by Paget, namely that a remnant of the plexiform anastomosis between the primitive olfactory artery and $A_1$ segment is the source of such fenestration.

숙련자와 미숙련자의 배드민턴 스매시 동작의 운동학적 비교 분석 (Kinematic Analysis of Badminton Smashing Between the Skilled and the Unskilled)

  • 류재청;김익상
    • 한국운동역학회지
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    • 제13권2호
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    • pp.139-160
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    • 2003
  • The purpose of this study was to suggest the guideline for scientific and quantitative skill acquisition methods of badminton smashing so that the novice could learn the motions of badminton smashing efficiently. The subject participated consisted of total 6 middle school students of the stilled(3) and the unskilled(3). The cinematographical experimental & Analysis equipments used in the study were composed of two Model D-5100 Video Cameras, a control point, a synchronization timer and Kwon3d motion analysis system. The conclusions obtained were as follows, 1. It was necessary for the unskilled to learn the smashing impact phase in situation of max. velocity of COG in order to minimize the timing loss phase. 2. Particularly. The power from segments of Power Zone must participate in utilization in sequence of order of trunk-upper arm- forearm-hand-racket segment in both the skilled and the unskilled.. 3. Therefore it was necessary for the unskilled to do smashing practice for cumulated sum of absolute & relative velocity transfer into shuttle cock after adjusting anterior-posterior tilting angle and max timing, in sequence of segment recruited.

선천성 식도폐쇄 및 기관식도루 -1례 보고- (Congenital Esophageal Atresia with Tracheoesophageal Fistula -A Case Report-)

  • 이문금;장운하
    • Journal of Chest Surgery
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    • 제27권6호
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    • pp.489-493
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    • 1994
  • Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

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