• 제목/요약/키워드: Surgical therapy

검색결과 1,554건 처리시간 0.027초

Treatment of Congenital Elbow Luxation using the Ilizarov Technique of Distraction Osteogenesis in a Dog

  • Kim, Byung-ju;Han, Kyung-Jin;Hong, Young-chae;Park, Ji-young;Jeong, Seong-Mok;Lee, Hae-Beom
    • 한국임상수의학회지
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    • 제34권4호
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    • pp.287-290
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    • 2017
  • A 6-month-old, 4.1 kg female Dachshund dog presented with intermittent non-weight bearing lameness of the right thoracic limb. Radiographs revealed caudolateral luxation of the right radial head and a shortened right ulna compared to the contralateral limb. Bone lengthening by distraction of the ulna using the Ilizarov technique was performed following ulnar osteotomy. The rate of distraction was 1.5 mm per day, adjusted a total of 3 times daily for a total distraction distance of 10 mm. The Ilizarov fixator was removed four weeks after surgery. The patient showed knuckling due to radial nerve injury that occurred during limb-lengthening. Corrective osteotomy was performed using a plate and pin for the luxation and deformity of the right radial head. The luxation of the radial head was successfully reduced following surgery. However, the knuckling persisted after surgery. Rehabilitation for radial nerve injury was performed using heat therapy, massage, a passive range of motion exercises, water treadmill exercises, neuromuscular electrical stimulation, leash-walking, and acupuncture. 15 months after surgery, the patient showed satisfactory weight-bearing ambulation without recurrence of lameness. The use of the Ilizarov technique is a good surgical option for the treatment of a patient with congenital elbow luxation.

인공 대동맥판막 기능부전을 일으킨 특발성 과호산구 증후군 -1예 보고- (Dysfunction of the Prosthetic Aortic Valve in Idiopathic Hypereosinophilic Syndrome -A case report -)

  • 유동곤;성규완;정상식;강길현;김종욱;박종빈
    • Journal of Chest Surgery
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    • 제40권4호
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    • pp.297-300
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    • 2007
  • 특발성 과호산구 증후군은 호산구 매개에 의한 조직 손상으로 인해 다발성 장기부전, 특히 심장을 침범하는 드문 전신성, 백혈구증식성 질환이다. 심장침범은 특발성 과호산구 증후군 환자의 75% 이상에서 일어난다. 심장증상은 심내막 하 섬유증, 제한성 심근병증, 판막부전, 그리고 말초동맥 혈전증을 유발하는 혈전이다. 이 질환은 남자에서 여자보다 9 : 1로 호발하고, $20{\sim}50$대에서 주로 발현하는 경향이 있으며 소아에서는 매우 드물다. 인공 대동맥판막부전을 나타낸 특발성 과호산구 증후군 환자(58세, 남자)를 인공판막 재치환 수술 후 부신피질호르몬제와 hydroxyurea 투여로 성공적으로 치료하였기에 보고하는 바이다.

기관지 내시경 후에 발생한 Bacillus Licheniformis 균혈증 (A Case of Bacillus licheniformis Bacteremia Associated with Bronchoscopy)

  • 홍태원;김효열;지명관;최정욱;용석중;신계철;리원연
    • Tuberculosis and Respiratory Diseases
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    • 제57권6호
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    • pp.553-556
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    • 2004
  • Bacillus종은 그람양성 간균으로 포자를 형성하며 주변 환경 어디에나 존재하여 임상 가검물에서 분리되는 경우 대부분 오염균으로 생각된다. B. licheniformis에 의한 감염증인 경우 외상, 면역저하, 주사약물남용과 연관성을 가지며, 적절한 항생제 사용과 카테타 제거나 수술적 국소조직 제거에 의해 잘 치유되는 특징이 있다. 그러나 위험인자가 없는 상태에서도 B. licheniformis 균혈증은 생길 수 있으며 본 증례에서도 58세의 위험인자가 없던 여자에서 기관지경 후에 B. licheniformis 균혈증이 발생하였고 다른 증례들처럼 경험적 항생제 치료 후에 합병증 없이 치유되었다.

연부 조직 육종의 생존 및 예후 인자 분석 (Analysis of Survival and Prognostic Factors in Soft Tissue Sarcomas)

  • 김한수;성상철;최인호;정진엽;조태준;김상림;정진영;한일규;이한구;이상훈
    • 대한골관절종양학회지
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    • 제5권4호
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    • pp.208-215
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    • 1999
  • The purpose of this study was to identify the independent clinicopathologic prognostic factors of soft tissue sarcoma affecting local recurrence, metastasis and survival. Retrospectively collected data from 130 patients with soft tissue sarcoma were analyzed. Patient, tumor and pathologic factors were analyzed by univariate and multivariate methods for the endpoints of local recurrence, metastasis and survival. In univariate analysis, wide surgical margin, adjuvant radiotherapy and age younger than 40 years reduced local recurrence. Tumor size larger than 5cm was related with a higher rate of metastasis. Patients with metastasis at initial presentation and with a large tumor size had a low survival rate. In multivariate analysis, adjuvant radiotherapy and young age were significantly correlated with a low local recurrence rate. In conclusion, patients with metastasis at initial presentation and a large tumor size had a reduced survival rate. Independent adverse prognostic factors for local recurrence were old age and not undergoing adjuvant therapy.

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The Efficacy of Coblator in Turbinoplasty

  • Lee, Keun-Cheol;Cho, Jeong-Min;Kim, Seok-Kwun;Lim, Kwang-Ryeol;Lee, Sang-Yun;Park, Su-Seong
    • 대한두개안면성형외과학회지
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    • 제18권2호
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    • pp.82-88
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    • 2017
  • Background: Turbinate hypertrophy is one of the common causes of chronic nasal obstruction. In principle, therapeutic guidelines recommend medical treatment. Failure to treat turbinate thickening despite drug therapy may indicate the need for surgery. The main aim of this study was to determine the effect of radiofrequency surgery, among various other surgical procedures, on people with both nasal septal deviation and turbinate hypertrophy. Methods: Among people with nasal deviation who visited the subject hospital between July 2008 to July 2014, 21 people with nasal septal deviation and severe turbinate hypertrophy before their surgery had undergone septoplasty with turbinoplasty using radiofrequency combined with septoplasty. The degree of the turbinate's hypertrophy was appraised in all the patients before and after the surgery using the rhinoscopy, and acoustic rhinometry was objectively carried out. The subjective effect of the turbinoplasty using radiofrequency was explored through the visual analog scale (VAS) score. Results: The degree of contraction of the nasal mucosa after the rhinoscopy changed from Grades 3 and 4 (100%) to Grades 1 and 2 (95.2%) and Grades 3 (4.8%). The minimal cross-sectional area significantly increased from $0.44{\pm}0.07$ to $0.70{\pm}0.07cm^2$ (p<0.05). The nasal cavity volume increased from $4.79{\pm}0.49$ to $6.76{\pm}0.55cm^2$ (p<0.05). The subjective symptoms evaluated with VAS score a year after the surgery significantly improved (p<0.05). Conclusion: Turbinoplasty using Coblator with septoplasty is an effective treatment method because it expands nasal cavity, has a low incidence of complications, subjectively improves symptoms, and has short treatment duration.

치주질환에 이환된 환자에서 구치 상실 치열 수복을 위한 임플란트 수복 (Implant-Supported Fixed Prostheses for the rehabilitation of distal free end in periodontally compromised dentitions Number of fixtures affecting bone tissue change)

  • 이승원;김영수
    • Journal of Periodontal and Implant Science
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    • 제35권1호
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    • pp.53-63
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    • 2005
  • Number of fixtures supporting prosthesis for rehabilitation of partial edentulism in distal area is an important factor in distal area to the bone tissue response around dental implant. Optimal number and optimal positioning of dental implant has leaded to the stable condition of bone tissue and successful long-term treatment outcome. This clinical and radiographic study was performed to document and evaluate the short-term result of occlusal rehabilitation by means of implant-supported fixed prostheses (ISPs) especially for partial edentulism in distal area in patients treated for advanced periodontal disease and to verify the number of fixture affecting the bone tissue response. A total of 30 consecutive patients referred because of advanced periodontal disease were included. Before the implant therapy was initiated, periodontal treatment was performed and the outcome evaluated during at least a 6-month period. An individual maintenance care program was designed for each patient. All 75 implants were placed using a 2-stage surgical approach. The patients were divided into 2 groups, in one of which two fixtures were placed and in the other of which three fixtures were placed with tripodal geometry. Following installation of the ISPs, all patients underwent a baseline examination including evaluation of i) oral hygiene, and ii) periodontal/ peri-implant conditions, and iii) radiographs. These examinations were repeated annually during the 1 or 2-year observation period. The results were as follows: 1.No single implant was lost during the observation follow-up period. 1.The percentage of plaque harboring surfaces and bleeding units upon probing were found to be low (<10%), and no soft tissue complications were recorded. 1.Two-fixture group showed bone destruction ranged from 0.0mm to 1.5mm and the mean was 0.31mm. Three-fixture group showed more bone destruction of 0.51mm. There was no statistically difference between two groups. These results suggested that the factor for success is not the number of fixture but the strict maintenance of peri-implant tissue health and initial stability of fixture.

Platelet - derived growth factor-BB와 Insulin Iike gowth factor-1이 e- PTFE를 이용한 치근 이개부의 조직유도재생에 미치는 영향 (The Effect Of Platelet - Derived Growth Factor And Insulin - Like Growth Factor On The Guided Tissue Regeneration In The Treatment Of Human Furcation Involvement)

  • 주애라;김성조;최점일
    • Journal of Periodontal and Implant Science
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    • 제26권1호
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    • pp.80-88
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    • 1996
  • The aim of the present investigation was to see the effect of combined use of PDGF BB and IGF -1 on the guided tissue regeneration(GTR) using barrier membrane in the treatment of human furcation involvement. Twelve patients with initially diagnosed as having moderate to advanced adult periodontitis with mandibular class II buccal furcation defects have been wer selected. Initial scaling and root planing has been performed and baseline data consisting of probing depths and attachment levels have been recorded prior to surgical procedures. The GTR procedures using either barrier membrane(control : ePTFE) alone or together with the application of PDGF - BB and IGF -l(experimental : ePTFE+PDGF/IGF) have been done under the routine guidelines. During the surgery, the distance from CEJ either to the bottom of the bone defects(CEJ - BD) or to the bone crest(CEJ-BC) were measured. Horizontal distance to the deepest area in the furcal defects were measured from the reference line connection the most prominent bony walls of the two buccal roots. 6 months following the GTR therapy, all the measurements were made repeatedly. The probing attachment gain of the experimental and the control grous were 2.14mm and l.07mm, respectively with no statically significnant difference. Amont of vertical bone fill in the experimental and the control groups were 2.43mm and 2.29mm, rexpectively. Amonut of horizontal bone fill were 2.86mm in the experimental group and 2.17mm in the control group, respectively. However, there were no significant differences in the amount of bone fill(both vertical and horizontal)between the two groups.

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결핵성 흉막염 치료 후 반복되는 가성유미흉의 수술적 치료 (Surgical treatment of recurrent pseudochylothorax occurring after therapy of tuberculous pleurisy)

  • 이재령;김우식;정은정;정유나;이희숙;조기호;이지연
    • Journal of Yeungnam Medical Science
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    • 제31권1호
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    • pp.65-68
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    • 2014
  • Pseudochylothorax is an uncommon pleural effusion disease characterized by the presence of cholesterol crystals or high lipid content not resulting from a disrupted thoracic duct. Most of the cases reported so far had been found in patients with long-standing pleural effusion due to a chronic inflammatory disease such as old tuberculous pleurisy or chronic rheumatoid pleurisy. Authors encountered a case of pseudochylothorax in a 45-year-old man who had been treated for tuberculous pleurisy 6 years before his visit to authors' hospital. After that, he had visited the emergency department many times for removal of pleural effusion. The patient's chest X-ray revealed dyspnea and large left-sided pleural effusion. Although a large amount of pleural fluid was removed with a drainage catheter, massive pleural effusion was likely to recur, and the underlying lung was able to fully re-expand. Accordingly, decortication was done, and the patient's symptom was improved without postoperative complications.

Deep Vein Thrombosis Due to Hematoma as a Rare Complication after Femoral Arterial Catheterization

  • Kim, Minsoo;Lee, Jong-Young;Lee, Cheol Whan;Lee, Seung-Whan;Kang, Soo-Jin;Yoon, Yong Hoon;Om, Sang Yong;Kim, Young-Hak
    • Journal of Yeungnam Medical Science
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    • 제30권1호
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    • pp.31-35
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    • 2013
  • Hematoma is quite a common complication of femoral arterial catheterization. However, to the best of our knowledge, there have been no previous studies regarding deep vein thrombosis (DVT) caused by compression of a vein due to a hematoma. We report a case of a hematoma developing after femoral arterial catheterization and causing extensive symptomatic DVT. A 59-year-old male was seen in our Emergency Department with right lower leg swelling 15 days after coronary stent implantation performed using right femoral artery access. Computed tomographic (CT) scanning revealed a large hematoma (45 mm in its longest diameter) compressing the common femoral vein and with DVT from the right external iliac vein to the popliteal vein. Due to the extensive DVT involvement, we decided to release the compressed common femoral vein by surgical evacuation of the large hematoma. However, even following evacuation of the hematoma, as the DVT did not resolve soon, further mechanical thrombectomy and catheter-directed thrombolysis were performed. Angiography then showed nearly resolved DVT, and the leg swelling was improved. The patient was discharged with the anticoagulation medication, warfarin.

Comparison of WHO and RECIST Criteria for Evaluation of Clinical Response to Chemotherapy in Patients with Advanced Breast Cancer

  • Khokher, Samina;Qureshi, Muhammad Usman;Chaudhry, Naseer Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3213-3218
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    • 2012
  • When patients with advanced breast cancer (ABC) are treated with neoadjuvant chemotherapy (NACT), efficacy is monitored by the extent of tumor shrinkage. Since their publication in 1981, World Health Organization (WHO) guidelines have been widely practiced in clinical trials and oncologic practice, for standardized tumor response evaluation. With advances in cancer treatment and tumor imaging, a simpler criterion based on one-dimensional rather than bi-dimensional (WHO) tumor measurement, named Response Evaluation Criteria in Solid Tumors (RECIST) was introduced in 2000. Both approaches have four response categories: complete response, partial response, stable disease and progressive disease (PD). Bi-dimensional measurement data of 151 patients with ABC were analysed with WHO and RECIST criteria to compare their response categories and inter criteria reproducibility by Kappa statistics. There was 94% concordance and 9/151 patients were recategorized with RECIST including 6/12 PD cases. RECIST therefore under-estimates and delays diagnosis of PD. This is undesirable because it may delay or negate switch over to alternate therapy. Analysis was repeated with a new criteria named RECIST-Breast (RECIST-B), with a lower threshold for PD (${\geq}10%$ rather than ${\geq}20%$ increase of RECIST). This showed higher concordance of 97% with WHO criteria and re-categorization of only 4/151 patients (1/12 PD cases). RECIST-B criteria therefore have advantages of both ease of measurement and calculations combined with excellent concordance with WHO criteria, providing a practical clinical tool for response evaluation and offering good comparison with past and current clinical trials of NACT using WHO guidelines.