• 제목/요약/키워드: Surgical result

검색결과 1,816건 처리시간 0.026초

흉추강 협착증의 수술적 치료 결과와 예후인자에 관한 분석 (The Analysis on Surgical Result and Prognostic Factors of Thoracic Spinal Stenosis)

  • 장웅규;정상기;김동윤;정천기;김현집
    • Journal of Korean Neurosurgical Society
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    • 제30권6호
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    • pp.761-768
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    • 2001
  • Objective : To describe the underlying causes, surgical results, and prognostic factors in thoracic stenosis causing myelopathy, retrospective analysis for 28 cases of thoracic stenosis with surgery was performed Materials & Method : Twenty-eight patients(male, 15 ; female, 13) who underwent decompressive surgery for thoracic stenosis between 1987 and 1997 were analyzed. The mean age was 49 and the mean follow-up was 30.6 months. Statistical analysis with $SPSS^{(R)}$ was performed. Chi-square test was used for the analysis of relationship between subjects and multivariate analysis with general linear model was used to find prognostic factors. Result : Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was done in 23 cases, anterior decompression in four cases, and combined decompression in one case. Ossification of ligamentum flavum was found in 18 cases, facet hypertrophy in 13, ossification of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively, 16 patients improved functionally and 4 patients worsened. The group of which initial symptom duration was less than two years showed better result(p=0.003). The group with sufficient decompression and no additional proximal stenosis had better outcome(p=0.002, p=0.001). Conclusion : Chronic myelopathy caused by thoracic stenosis can be reversible with appropriate decompression.

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Animal Model for the Evaluation of Repair of Injured Inferior Alveolar Nerve with Nerve Growth Factor

  • Lee, Jae-Yoon;Park, Suhyun;Heo, Hyun-A;Pyo, Sung-Woon
    • Journal of Korean Dental Science
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    • 제6권2호
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    • pp.58-66
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    • 2013
  • Purpose: The inferior alveolar nerve (IAN) can be damaged as a result of minor oral surgical procedure such as third molar extraction or implant placement. Repair of the injured IAN involves difficulty of access, and research studies are limited to elucidating the process of regeneration by surgical methods. This study sought to establish the rabbit animal model to apply polymeric membrane functionalized with nerve growth factor after a crush lesion for the evaluation of nerve regeneration using the electrophysiologic method. Materials and Methods: The IAN of 2 adult male New Zealand white rabbits (4 nerves) were exposed bilaterally, and crush injury rendered by jeweler's forceps was applied. Nerve conduction velocity was examined electrophysiologically using electromyography before, after, and 4 weeks after the crush injury. To evaluate the regeneration, the pattern of action potential of IAN was recorded, and the characteristics of neurons were histologically observed. Result: After the crush injury, afferent activity decreased in the injured group. Electromyography could not be recorded after four weeks because tissues surrounding the injured nerve collapsed. Decrease in the mean number of axons was observed in the injured part with membrane. Conclusion: Despite the limited result, the present animal model study may provide a possible way to research on the methods of enhancing the recovery of nerve injuries in clinical situations. For clinically widespread acceptance, however, it should gain more consecutive and scientific evidences.

경추간판탈출증에 대한 미세 전측방 Tunnel Approach의 결과 (Results of Microsurgical Anterolateral Tunnel Approach for Cervical Disc Herniation)

  • 장우영;김근수;이정청;김철진;최하영;현수남;한동한
    • Journal of Korean Neurosurgical Society
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    • 제30권5호
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    • pp.600-604
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    • 2001
  • Objective : The authors report the microsurgical anterolateral tunnel approach for the treatment of the cervical disc diseases and its postoperative surgical results. Methods : All surgical procedures followed the method of classical microsurgical anterior discectomy. Small tunnel(7-8mm) was made on the disc space reaching to the posterior longitudinal ligament. The disc materials and bony spurs were removed through this tunnel. Thirty-one patients of cervical disc herniation(24 cases with pure disc herniation, 7 cases with combined cervical spondylosis) were evaluated on the symptoms, conformation in plain X-ray, C-T, and MRI. The follow up time was over 2 years. Results : Postoperatively the result(following the out come scale) was excellent and good in Twenty-nine patients. One with fair result showed remnant disc particle and spur and another one is combined with cord contusion. One patient with lesion in C 3-4 space and two cervicothoracic junction showed excellent result. Two patients with osteoporosis also showed good results. Cervical spine curvature and disc space height were not changed on the plain X-ray and MRI in all patients. Twenty-nine patients were discharged within 3 days after surgery without any postoperative complications. Conclusions : The microsurgical anterolateral tunnel approach could be indicated for the treatment of patients with cervical disc diseases and with difficulty in achieving interbody fusion(the higher cervical level and cervicothoracic junction, osteoporosis etc.).

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부정유합의 치료 (Treatment of Malunion)

  • 김준우;박경현;오창욱
    • 대한정형외과학회지
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    • 제56권2호
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    • pp.117-124
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    • 2021
  • 비록 수술적 치료의 발전에 의해 부정유합의 발생은 감소하였으나 복합적 골절 또는 동반된 손상 등으로 인하여 드물지 않은 합병증이다. 관절 연골에 과한 하중이나 관절의 불안정성이 예상되는 부정유합이 있다면 교정 절골술이 필요하다. 부정유합에 대한 절골술을 시행하기 위해서는 수술 전 계획이 매우 중요하다. 적절한 계획이 없을 경우 의인성 부정정렬, 수술중 골절, 변형의 재발, 연부조직의 손상과 같은 심각한 합병증이 따르게 된다. 또한 적절한 환자를 선택하지 않았을 경우 불량한 기능적 결과가 나타날 수 있다. 본 종설은 부정유합을 치료하기 위하여 수술적 적응증, 수술 전 계획, 그리고 수술방법과 고정물 종류에 따른 다양한 교정 절골술의 방법에 대하여 기술하였다.

Clinical Implications of p57KIP2 Expression in Breast Cancer

  • Xu, Xiao-Yin;Wang, Wen-Qian;Zhang, Lei;Li, Yi-Ming;Tang, Miao;Jiang, Nan;Cai, Shou-Liang;Wei, Liang;Jin, Feng;Chen, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권10호
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    • pp.5033-5036
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    • 2012
  • Objective: To study the relationship between expression of $p57^{KIP2}$ and prognosis and other clinicopathological parameters in invasive breast cancers. Methods: We assessed the expression of $p57^{KIP2}$ in 89 cases of invasive breast cancer and 20 cases of normal breast tissue by immunohistochemical methods and analyzed the results with SPSS software (ver. 16.0). Result: The positive expression rates of $p57^{KIP2}$ protein in the invasive breast cancers and surrounding normal tissue were 30.3% (27/89) and 65% (13/20), respectively. Cases with no $p57^{KIP2}$ expression exhibited a significantly higher post-operative distant metastasis rate than those with $p57^{KIP2}$ expression (37.9% vs. 14.8%; P = 0.01). DFS analysis showed that $p57^{KIP2}$-/C-erbB-2+ tumors also exhibited a significantly higher post-operative distant metastasis rate than the other groups (66.7% vs. 29.2%; P = 0.007), as did $p57^{KIP2}$-/p53+ tumors (64.3% vs. 22.7%; P = 0.001). Survival analysis revealed that $p57^{KIP2}$ was associated with breast cancer-specific survival overall (P = 0.045, log-rank test). Subgroup analysis demonstrated that individuals with $p57^{KIP2}$-/C-erbB-2+tumors experienced significantly worse post-operative survival than those with $p57^{KIP2}$-/C-erbB-2- or other tumors (P = 0.006, log-rank test). $p57^{KIP2}$-/p53+ tumors were associated with significantly worse post-operative survival than $p57^{KIP2}$-/p53- or other tumors (P = 0.001, log-rank test). Cox regression analysis showed that $p57^{KIP2}$ was a non-independent prognostic factor for breast cancer (P = 0.303). Conclusions: $p57^{KIP2}$ is expressed at low levels in invasive breast cancer and is associated with better overall survival rate and disease-free survival in breast cancer patients, but it was a non-independent prognostic factor for breast cancer. Thus, the connection between $p57^{KIP2}$/p53 and $p57^{KIP2}$/C-erbB-2 may provide biomarkers for breast cancer.

A431 skin cancer cell에서 Esculetin의 MAPKs pathway를 통한 항암 효과 (Esculetin Suppresses the Growth and Proliferation of A431 Skin Cancer Cells via the MAPKs Pathway)

  • 성진영;김용민
    • 생약학회지
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    • 제53권4호
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    • pp.181-191
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    • 2022
  • As the incidence of skin cancer increases every year, non-surgical treatment methods for cancer are being sought. Esculetin, a natural dihydroxy coumarin, is attracting attention as a therapeutic agent for certain diseases, such as cancer, based on its broad pharmacological activity. In this study, the anticancer ability of esculetin was evaluated using the epidermoid carcinoma cell line A431. As a result of evaluating the apoptosis ability of esculetin by MTT assay, apoptosis was observed in a time-concentration-dependent manner regardless of the presence or absence of FBS. As a result of quantitative real-time PCR, esculetin reduced cyclin D1 mRNA in a time-concentration-dependent manner. In addition, as a result of western blotting, esculetin significantly inhibited phosphorylation of ERK, JNK, and p38 in a concentration-dependent manner. The results of this study suggest that esculetin has the potential to be used as an effective natural medicine for the treatment of skin cancer.

골격성 제III급 부정교합 환자의 2단계 치료후 경과에 대한 임상적 연구 (CLINICAL STUDY OF THE SKELETAL CL III MALOCCLUSION PATIENTS AFTER 2-PHASE SURGICAL-ORTHODONTIC TREATMENT)

  • 조윤주;김상중;김동률;석근정;홍광진;이정구;손홍범
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권6호
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    • pp.628-635
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    • 2000
  • The purpose of this study was to evaluate the result after 2-phase surgical-orthodontic treatment without preoperative orthodontic treatment for the skeletal Cl III malocclusion patient and to obtain an adequate protocol on the bases of this result. This retrospective study of ten patients who underwent 2-phase treatment were done to evaluate 1) the surgical stability and relapse pattern 2) the facial esthetics 3) the TMJ problem 4) the total time of the treatment. Results were followed : 1) The horizontal relapse of the mandible was 26.8% and didn't show significant differences compared to the conventional 3-phase treatment. But, it was considered that this amount of relapse was the sum of true relapse and autoratation of mandible due to decreased vertical dimension during orthodontic treatment. 2) It was estimated that there's no difference on the ratio of anterior facial height between the subjects and the normal patients. On the horizontal analysis, the mandible of the subjects was located more anteriorly than that of the normal patients. This result showed that there was a need for the accurate preoperative esthetic evaluation and the additional methods for reducing the relapse due to the occlusal interference. 3) Wide variation was noted on the TMJ symptoms of the subjects, however, it was estimated that there's no significant differencees of symptoms compared to that of the conventional 3-phase treatment on literatures. 4) The average of the overall period of treatment was 20.8 months and we obtained reduction of the treatment time compaired to 3-phase treatment on many literatures. Most of the results of this study were similar to the findings of the 3-phase treatment(preoperative orthodontic-orthognathic surgery-postoperative orthodontic), but total time of the treatment was shorter in patients with 2-phase treatment than in those with the conventional 3-phase treatment. With 2-phase treatment, we experienced many advantages compared to the conventional method considering that it was favarable conditions for the teeth, it had the flexibility for the treatment, and it could be the adequate treatment approach for the stomatognathic system. Although this retrospective pilot study had some limitations, due to small samples, the authors would hope that it could serve as a guide for the future researches, and the clinical applications.

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만성 족근 관절 외측 불안정성에서 변형된 Brostrom 술식이 결과에 영향을 미치는 관련 요소 분석 (Analysis of Affecting Factors of Modified Brostrom Procedure in Chronic Ankle Lateral Instability)

  • 이경태;양기원;배상원;이정훈
    • 대한족부족관절학회지
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    • 제6권1호
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    • pp.66-72
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    • 2002
  • Purpose: To evaluate the overall results and its major affecting factors(athlete/associated injury) of modified Brostrom procedure for chronic ankle lateral instability. Materials and Methods: Fifty-one patients (51 ankles) with chronic ankle lateral instability were sub-grouped athletes and non-athletes and again sub-grouped with associated injury and without associated injury. Associated injuries were osteochondral defect(6), peroneal tendon abnormality(10), os subfibularae(4), os subtibialae(4), anterior impingement(5) and loose body(2). The overall surgical results were evaluated and also see whether or not athletes and associated injury affect the result. Result: Of the 51 operations performed, there were 39 excellent, 8 good and 4 fair as a whole. Of the 24 athletes operated, there were 19 excellent, 3 good, and 2 fair. Among the 27 non-athletes, there were 20 excellent, 5 good and 2 fair results. The average time to ordinary life in the non-athlete group was 2.5 months and average time to sports activity in the athlete was 4.5 months postoperatively. Those who didn't have any associated injury had all excellent result, on the contrary, those who had associated injuries, 14 excellent, 8 good and 4 fair results. All the fair results were associated with osteochondral lesion of talus. Whether or not the patient is athlete does not affect the surgical results, but whether or not there were associated injuries does affect the surgical results. Conclusion: Modified Brostrom procedure for chronic ankle lateral instability itself is an excellent to good operation. This procedure can be used in athletic populations who need high demand of sports activity. But chronic ankle lateral instability with associated injury group showed variable, less satisfactory results than those without associated injury. Careful preoperative and intraoperative examination should be done to find out the associated injury with chronic ankle lateral instability.

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피부과용$CO_2$ 레이저의 공극(1.0mm및 1.6mm)차이에 따른 동작출력 파형변화에 관한 특성 연구 (Special quality research about action output waveform change by gap (1.0mm and 1.6mm)difference of skin excessive expense $CO_2$ Laser)

  • 김휘영
    • 한국컴퓨터산업학회논문지
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    • 제8권2호
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    • pp.107-112
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    • 2007
  • 피부과용 레이저 파장은 아주 얇은층의 조직두께에서 물의 흡수가 거의 90%이상 일어나는데 병소의 표피나 조직은 거의 물로 구성되어 흡수로 인해 증발효과를 가질 수가 있다. 표피를 절개, 층별로 증발 시킬 수 있으며 조직의 정확한 절개가 가능하다. 혈관이나 림프시스템에도 봉합수술이 가능하고 수술부위가 건조하고 눈으로 볼수 있고 무출혈 수술이 가능하다. 특히, 펄스에 대한 튜브양단 출력의 안정이 매우 중요함으로, 본 연구에서는 고주파 방식의 전력변환 장치를 사용하여 부피를 줄이고 의료용 레이저의 전류파형을 쉽게 제어할 수 있어 다양한 치료 효과를 낼 수 있다. ZVS(Zero Voltage Switching)나 ZVZCS(Zero Voltage and Zero Current Switching)를 도입하면 스위칭 손실을 줄일 수 있어 더욱 유리하다. 제안된 의료용 레이저의 전력부에는 1차측 도움에 의한 ZVZCS기법을 도입하여 넓은 부하 범위에서 안정된 soft-switching을 할 수가 있고 제어부는 microcontroller를 구성하여 출력전류 파형을 사용자가 임의의 형태를 갖도록 하였다. 설계 및 제작하여 실험한 결과, 기존장비에 비해 20%의 향상된 결과를 가져왔고, 추후 시스템적으로 보완을 하면 우수한 결과가 될 것으로 사려된다.

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뇌기저부 수막종의 임상분석 및 수술성적 (Clinical Analysis and Surgical Results of Skull Base Meningiomas)

  • 김영욱;정신;김재성;이정길;김태선;김재휴;김수한;강삼석;이제혁
    • Journal of Korean Neurosurgical Society
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    • 제29권11호
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    • pp.1437-1444
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    • 2000
  • 저자들은 10년동안 수술을 시행받았던 212례의 수막종 환자중 뇌기저부에 위치한 61례에 대한 임상 분석을 시행한 결과 다음과 같은 결과를 얻었다. 1) 본 연구기간중 뇌기저부 수막종 환자는 61례로 전체의 29%를 차지하였으며, 평균 추적기간은 약 52개월이었다. 2) 성비는 여성이 남성보다 약 2배 많았으며, 평균연령은 52세였다. 3) 위치별로는 후두개와가 가장 많았으며, 전체적으로는 접형골연부, 천막부 및 소뇌교각부가 대부분을 차지하였다. 4) 호발증상 및 징후로는 두통, 뇌신경마비 및 소뇌징후 순으로 나타났다. 5) 종양제거정도는 심슨등급 I, II로 전적출한 경우가 82%이었으며, 심슨등급 III로 아전적출한 경우가 18%이었다. 6) 병리조직결과는 양성이 85%로 대부분을 차지하였으며, 비정형성과 악성은 각각 10%, 5%를 차지하였다. 7) 술후 보조적 치료는 악성, 부분적출 및 재발한 경우에 사용하였다. 8) 술후 합병증으로는 뇌척수액누출, 뇌신경마비 및 간질 발작 순이었다. 9) 술후 사망한 경우는 수술후 사망한 1례와 종양 재발에 의한 사망 2례이었다. 10) 재발은 약 15%로 심슨등급 III와 악성인 경우에 높았으며, 재발 위치는 천막부, 접형골연 및 소뇌교각부 순이었다. 결론적으로 뇌기저부 수막종의 수술은 종양 주변부의 중요한 구조물이 위치함에 따라 낮은 사망률 및 합병증 발생률을 가지고 수술적 적출이 어렵지만, 술전 방사선학적 소견의 정확한 이해와 적절한 접근법의 선택, 뇌기저부 재건술이 술후 합병증의 감소 및 종양적출을 위해 필수라고 생각한다.

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