• 제목/요약/키워드: Surgical result

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전이성 폐암에 대한 외과적 치험 (Surgical treatment of Metastatic Lung Cancer)

  • 이종호;임용택;신용철;정승혁;김병열
    • Journal of Chest Surgery
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    • 제32권1호
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    • pp.27-31
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    • 1999
  • 배경: 최근 항암화학요법의 발달에도 불구하고 전이성폐암에 대한 예후는 불량하다. 이에비해 전이성폐암에 대한 외과적 요법후 좋은 결과를 보이는 보고가 증가하고 있다. 그래서 전이성 폐암에 대한 치료에 도움이 되고자 본원의 경우를 관찰하였다. 대상 및 방법: 1983년부터 1997년까지 수술적 치료를 했던 17례를 분석하였고 Kaplan-Meier 방법으로 5년생존률을 구하였다. 결과: 평균연령은 42.8세였고 남녀비는 10:7이었다. 수술은 단일폐엽절제술이 8례, 전폐적출술이 3례, 부분절제술이 1례, 쌍폐엽절제술이 1례, 폐엽절제술 및 부분절제가 3례있었다. 술후 5명이 사망하였고 이중 재발로 인한 것은 3례였다. 나머지 12례의 환자들중 3명은 재발하여 현재 외래추적관찰중이며 9명은 재발없이 건강한 상태로 외래추적 관찰중에 있다. 술후 평균 생존기간은 40.5개월이었다. Kaplan-Meier 방법으로 구한 5년생존율은 60.4%였다. 결론: 앞으로 더많은 경험이 필요하지만 전이성폐암에 대해서 더 적극적인 수술적치료를 하는 것이 필요하다고 생각한다.

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의료장비 도입계획과 실제이용에 대한 실태분석 (Medical Equipment Purchasing Plan and Analysis of Actual Utilization)

  • 이학선;유승흠;이해종;김성규
    • 한국병원경영학회지
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    • 제5권2호
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    • pp.22-39
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    • 2000
  • The purpose of this study was to determine the difference between estimated profit and utilization of medical equipment upon purchasing and actual results at one teaching hospital in Seoul, Korea Medical equipments over $100,000 from 1992 to 1997 were selected and results were as follows: 1. Twenty equipments out of thirty exceeded estimated profits and the difference was 3.98 billion won and ten equipments did not reach the estimated profits and 5.5 billion won was the difference. Diagnostic equipment exceeded the estimated profit which surgical equipment didn't. 2. Eleven equipments exceeded estimated utilization, which showed 100%. In the mean time, eighteen equipments didn't reach the estimated utilization, which was 71%. Diagnostic equipment showed the less estimated utilization than surgical equipment 3. Twenty-one equipments showed the 6.83 billion won profits and nine equipments showed the 1.6 billion won deficits. Diagnostic equipment was more profitable than surgical equipment. Finally. diagnostic equipment helped improving hospital management than surgical equipment. 4. Main factors which showed the big difference from the initial plan were lacking reasonable estimated method, no evaluation system for purchase, emphasis in medical treatment, excessive expenditure in maintenance, duplicated investment for medical equipment and leadership commitment. As a result. Substantial planning is required from the requesting department in consideration of estimated profit and utilization and systematic quality control is needed to confirm. Also, One-sided decision making should be avoided to purchase a high cost medical equipment and efforts should be made in examining carefully and developing a reasonable analytic method.

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경추추간판 탈출증환자의 감압치료 병행효과에 대한 임상적 연구 (The Clinical Studies for Non Surgical Spinal Decompression Treatment on Cervical Disc Herniation)

  • 서상경;김병정;박국지;강준혁;김성기;서덕원
    • 한방재활의학과학회지
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    • 제21권4호
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    • pp.131-143
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    • 2011
  • Objectives: The purpose of this study is to make a survey of the effectiveness of the non surgical spinal decompression treatment in patients with cervical disc herniation documented on magnetic resonance imaging(MRI). Methods: We studied about 27 cases of cervical disc herniation which were treated with non surgical spinal decompression and other medical treatment (acupuncture, interferential current therapy and ice poultice). Each patient has been treated with spine decompression and other medical treatment. And degree of improvement has been evaluated by short form-McGill pain questionnaire(SF-MPQ), visual analogue scale(VAS) and neck disability index(NDI) before treatment and 5th, 10th times after treatments. Results: 1. The VAS SF-MPQ and NDI scores showed statistically significant improvement after 5th and 10th treatment. 2. The VAS, SF-MPQ and NDI scores after 5th treatment showed better improvement than those of after 10th treatment. 3. The VAS, SF-MPQ and NDI scores in Subacute stage showed more statistically significant improvement among the other stages. Conclusions: As a result, non surgical spinal decompression treatment has clinical effects of pain reduction on patient with cervical disc herniation.

Cone-Beam CT를 이용한 악교정 수술용 스텐트 제작과 임상 적용 (SURGICAL STENT FABRICATION AND CLINICAL APPLICATION FOR ORTHOGNATHIC SURGERY USING Cone-Beam CT)

  • 김용일;김종렬;김성식;손우성;박수병
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권2호
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    • pp.158-166
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    • 2009
  • The application of CT with basis on 3 dimensional-reconstruction is getting more widely practiced. With the data obtained from cone-beam computed tomography(CBCT), not only the diagnosis of the patient with skeletal abnormality but also the virtual simulation of the orthognathic surgery were performed and its application would be popular in orthodontic field. We reported a case, a 19-year old man who was diagnosed mandibular prognathism and required orthognatic surgery. In this case, the virtual orthognathic surgery was simulated and surgical wafer was fabricated by using CBCT data. That wafer was applied the actual orthognathic surgery. After preoperative orthodontic treatment, we prepared surgery as follows. : (l)Acquisition of 3D image data, (2)Reconstruction of 3-dimensional virtual model, (3)Virtual model surgery, (4)Extraction of stere-olithographic image, (5)Check-up for occlusal interference, (6)Fabrication of surgical stent by stereolithography. Bilateral sagittal split ramus osteotomy was operated and used stereolithographic surgical stent. 1 month later, we superimposed CBCT datas of virtual surgery and that of actual surgery, and then compared the result. CT data's application for othognathic surgery yielded satisfactory outcomes.

심미적 부위에서 외과적 정출술을 이용한 임상 치관 연장술 (Clinical crown lengthening procedure using surgical extrusion in esthetic region)

  • 임현창;김민수;홍지연;정의원;김창성;조규성;채중규;김종관;최성호
    • Journal of Periodontal and Implant Science
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    • 제38권3호
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    • pp.557-564
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    • 2008
  • Purpose: Various methods are used in clinical crown lengthening procedure, Esthetic is more important in anterior region than in posterior region. Therefore when performing clinical crown lengthening procedure in esthetic region, clinicians should choose method which doesn't impair esthetic. Surgical extrusion could be a good method to achieve esthetic results. Material and Methods: Two patients were scheduled to clinical crown lengthening procedure in esthetic region. Teeth were extruded with periotome carefully to the intended level. Extruded teeth were anchored with sutures. Sutures are removed after 7day. Restorations were seated after extruded teeth were stabilized. Result: Five to six months later, both cases showed favorable esthetic outcome that were harmonious with adjacent teeth. Conclusion: When clinicians are to do clinical crown lengthening procedure in esthetic region, predictable esthetic outcome could be achieved with surgical extrusion.

고위의 전교통동맥 동맥류에서의 Pterional Approach와 Interhemispheric Approach의 수술적 비교 분석 (Surgical Comparison of Pterional Approach with Interhemispheric Approach for High Positioned Anterior Communicating Artery Aneurysms)

  • 박강화;조철민;김형동
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.197-202
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    • 2001
  • Objective : The purpose of this study is to evaluate and compare surgical results of pterional(fronto-temporal) approach and interhemispheric approach for the high positioned anterior communicating artery aneurysm with our surgical experience. Methods : During the period between May 1990 and May 2001, 263 anterior communicating aneurysms were treated at the department of neurosurgery of Dong-A university hospital. Among them, 175 patients were operated by same operator. Thirty six out of the 175 cases were high positioned anterior communicating artery aneurysms located more than 15mm above the anterior clinoid process. Results : Pterional approaches were applied in 32 cases and interhemispheric approaches were applied in 4 cases of total 36 cases of the high positioned anterior communicating artery aneurysms. The 32 cases of pterional approach resulted in Good Recovery 20/32(63%), Moderate Disability 6/32(19%), Severe Disability 4/32(12%) and Dead 2/32(6%), and 4 cases of interhemispheric approach resulted in GR 3/4(75%) and MD 1/4(25%). Relatively, pterional approach showed poorer result on high positioned anterior communicating artery aneurysm located more than 19mm above the anterior clinoid process with GR 5/13(39%), MD 3/13(23%), SD 3/13(23%) and Dead 2/13(15%). Conclusion : Interhemispheric approach is preferable to pterional approach for certain cases of high positioned anterior communicating artery aneurysm located more than 19 mm above the anterior clinoid process because it provides adequate orientation to the regional anatomy, less retraction of frontal lobe and preservation of the olfactory tract and gyrus rectus without any surgical complications.

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뇌기저동맥 체간부에 발생한 뇌동맥류 결찰술 - 증례보고 - (Clipping of Basilar Trunk Aneurysm - Case Report -)

  • 양태기;김철진;안병조
    • Journal of Korean Neurosurgical Society
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    • 제30권sup1호
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    • pp.128-132
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    • 2001
  • 뇌기저동맥 체간부에 존재하는 동맥류는 매우 희귀하며 그 수술적 치료는 복잡한 해부학적 구조와 근접해있는 중요한 신경혈관 구조때문에 수술적 접근이 매우 어려운 부위이다. 산화 단층촬영과 자기공명영상의 발달은 두개저 병변을 정확히 진단할 수 있게 하였고 두개저 부위의 수술적 접근에 많은 발전을 가져오게 하였다. 뇌기저동맥 체간부에 존재하는 동맥류의 수술 방법중의 하나로 저자들은 소뇌와 측두엽의 견인이 적어 소뇌 부종을 극소화 할 수 있고 와우, 미로, 안면신경등의 구조물을 보존하여 청력손실, 안면신경마비등의 합병증이 없고 횡정맥동, S상정맥동의 보존뿐만 아니라 Labbe's 정맥을 보존할 수 있으며 수술시야가 비교적 좋은 장점들이 있는 후미로 전S상정맥동 경천막을 통한 추체로접근법을 이용하여 뇌기저동맥 체간부에 발생한 동맥류의 직접 결찰수술을 시행하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

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하악골 후퇴증의 외과적 치험례 (A Case Report of a Surgical Correction of the Mandibular Retrusion)

  • 임난희;박진호;진병로;이희경
    • Journal of Yeungnam Medical Science
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    • 제12권2호
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    • pp.393-399
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    • 1995
  • 심한 하악 후퇴증은 교정치료만으로 성공적인 결과를 얻을 수 없으며 골절단술, 이부성형술등 외과적 교정이 고려되어야 한다. 설골상근의 장력에 의한 회귀현상을 최소화하기 위해 수술시 하악 체부를 전방회전시킴과 동시에 가능한 전방으로 overcorrection한다. 저자등은 구미인에 비해 발생빈도가 적은 하악 후퇴증을 주소로 내원한 환자를 양측성 하악골 시상절단술과 이부 성형술을 통하여 만족할만한 안모개선 및 교합관계 개선을 이루었기에 이에 보고하는 바이다.

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A Case Series of Symptomatic Distal Biceps Tendinopathy

  • Lee, Jung Hyun;Kim, Kyung Chul;Lee, Ji-Ho;Ahn, Kee Baek;Rhyou, In Hyeok
    • Clinics in Shoulder and Elbow
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    • 제21권4호
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    • pp.213-219
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    • 2018
  • Background: The study of conservative and surgical treatment of distal biceps tendinopathy and associated biceps tendon partial rupture. Methods: Twenty-one cases with distal biceps tendonitis and partial ruptures were studied who visited Pohang Semyeong Christianity Hospital from June 2010 to August 2017. The mean age was 57.1 years (39-69 years), 14 males and 7 females. The mean duration of symptom at the time of first visit was 4.9 months (0.2-14 months). Ultrasonography and magnetic resonance imaging were performed for patients with severe symptoms. According to the severity of the symptoms, splint immobilization, oral nonsteroidal anti-inflammatory drugs, and ultrasound-guided steroid injection were performed. Surgical treatment was performed if the patient did not respond to conservative treatment for 3 to 6 months or longer. Results: There were 9 cases of partial rupture of the distal biceps tendon associated with distal biceps tendinopathy on imaging studies. Conservative treatment showed symptomatic improvement in 16 of 21 cases. In 4 cases with a relatively mild symptom, anti-inflammatory analgesics and intermittent splinting showed good result. In 12 cases, symptoms improved after ultrasonography-guided steroid injection. Surgical treatment was performed on 5 cases that did not respond to conservative treatment. Conclusions: Conservative treatment of distal biceps tendinopathy may promise good results. However, in case of partial tear of the distal biceps tendon and refractory to conservative treatment, surgical treatment may be needed.

2단 절개 형태를 가지는 악교정 수술 장치 연구 (A Study of Orthognathic Surgical Guides with Two-stage Split Path)

  • 김민욱;박충환;노지형;정의성;박영상;김동국;서요한;우영재;이종민
    • 대한의용생체공학회:의공학회지
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    • 제43권6호
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    • pp.382-389
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    • 2022
  • In this study, the accuracy of the orthognathic surgical guides with single-stage split path was upgraded to realize orthognathic surgical guides with two-stage split path and simulated surgery was performed to verify its accuracy. As a result, the average error distance between the simulation model and the scan model was + 0.289 / - 0.468 mm (standard deviation 0.128), which was confirmed to be within ± 0.5 mm, which is a clinically acceptable level. Also, there was no significant difference compared with the average value of + 0.313 / - 0.456 mm (average standard deviation 0.106) of the conventional single-stage split path type device. It is judged that the use of this device can contribute to the reduction of surgical time and increase in accuracy since a separate finishing operation for bone preparation is unnecessary.