• 제목/요약/키워드: Transection

검색결과 118건 처리시간 0.028초

외상성 췌장 경부 절단에서 시행된 Binding 췌위장문합술 1례 (A Case of a Traumatic Pancreatic Neck Transection Treated with a Binding Pancreaticogastrostomy)

  • 설영훈;이상일;전광식;송인상
    • Journal of Trauma and Injury
    • /
    • 제26권1호
    • /
    • pp.18-21
    • /
    • 2013
  • Pancreatic injury following blunt abdominal trauma is rare, but it has high morbidity and mortality. Various treatments have been attempted, but none has yet been clearly established. The pancreatic neck transection is usually managed by using a distal pancreatectomy with or without a splenectomy. However, pancreatic insufficiency and the risk of post-splenectomy infection remain significant problems. To avoid these problems in patients with a pancreatic neck transection, one may use a pancreaticoenteric anastomosis as a treatment option, but a pancreatic fistula from the pancreaticoenteric anastomosis remains a significant cause of morbidity and mortality. Recently, several reports proposed the binding pancreaticogastrostomy to minimize the possibility of a postoperative pancreatic fistula developing after pancreatic surgery. Thus, we report a case of a traumatic pancreatic neck transection successfully treated with a binding pancreaticogastrostomy.

외상성 대동맥 절단 -1례 보고- (Traumatic Aortic Transsection -Report of A Case-)

  • 류한영
    • Journal of Chest Surgery
    • /
    • 제28권9호
    • /
    • pp.881-884
    • /
    • 1995
  • Improvements in the operative management of traumatic aortic transection have resulted in safe and expeditious repair. Nonetheless, multisystem injuries continue to inflict significant numbers of deaths. We have experienced a case of acute traumatic aortic transection in 41 years old male patient by a traffic accident. The transection was just distal to the origin of the left subclavian artery. We have done a synthetic graft interposition under left atrium to left femoral artery bypass with centrifugal pump. His postoperative course was smooth, and discharged without any complications.

  • PDF

백서의 좌골신경 절단 후 비복근의 자기공명영상 신호강도 변화와 근전도 소견의 관계 (Correlation between Magnetic Resonance Image Signal Changes and Electromyographic Findings after Sciatic Nerve Transection in the Rat)

  • 이주환;이장철;김동원;박기영;이성문
    • Journal of Korean Neurosurgical Society
    • /
    • 제29권1호
    • /
    • pp.101-107
    • /
    • 2000
  • Objectives : The evaluation of peripheral nerve injuries has traditionally relied on a clinical history, physical examination, and electrodiagnostic studies. The purpose of the present study was to examine serial magnetic resonance image(MRI) changes following acute muscle denervation under experimental conditions and to identify potential advantages and disadvantages of this use of MRI. Methods : An experimental transection of right sciatic nerve on Spargue-Dawley rats was performed. MRI was performed with T1-weighted spin-echo and STIR sequences. The imaging findings were compared with EMG in order to determine its sensitivity relative to this standard procedure. A simultaneous histopathological study provided information about the morphological basis of the imaging findings. Signal intensities were expressed as a ratio of abnormal to normal. Results : The signal intensity ratio of muscles with the STIR sequence was increased significantly at 2 weeks after sciatic nerve transection(p<0.05), although definite signal change was seen as early as 4 days postdenervation in one. EMG revealed significant denervation potential from 3 days after nerve transection. Diffuse cell atrophy was revealed hostologically at 2 weeks after transection, which was at the same time of significant signal change in MRI. Conclusion : MRI signal changes in denervated muscles secondary to nerve injury correlate with the degree of muscle atrophy on histologic examination. In addition to EMG, MRI can document the course of muscle atrophy and mesenchymal abnormalities in denervation. These results indicate that MRI can play a complementary role in the evaluation of patients with denervation.

  • PDF

좌골신경 손상 모델에서 보양환오탕 처리에 의한 축삭 재생반응성 분석 (Improved axonal regeneration by Boyanghwano-tang treatment in mice given sciatic nerve injury)

  • 장인애;김기중;남궁욱
    • 혜화의학회지
    • /
    • 제25권1호
    • /
    • pp.99-108
    • /
    • 2016
  • While axons in the peripheral nerve can regenerate and lead to functional recovery to a certain extent after injury, its efficacy varies depending on the severity and duration of the injury. Here, we investigated the effects of Boyanghwano-tang (BYHOT) treatment on the regenerative responses in the sciatic nerves after prolonged transection and coaptation surgery. In mice given crush injury, axonal regeneration was completed when analyzed 1 week later and did not show any difference in regenerative reponses in the distal portion of the nerve between saline- and BYHOT-treated groups. In animal models with transection and reconnection, axonal regeneration was markedly retarded compared to animals with crush injury. Regenerating axons were extended into the reconnected distal portion of the nerve more actively in animals treated with BYHOT than saline controls. Cdc2 protein was similarly induced in nerves with crush injury and with transection and recollection, and its level was lower in BYHOT-treated animal than saline control when measured 2 weeks after nerve reconnection. These results suggest that BYHOT may be useful to promote axonal regeneration in the peripheral nerve after severe injury.

Setting the Stomach Transection Line Based on Anatomical Landmarks in Laparoscopic Distal Gastrectomy

  • Hosogi, Hisahiro;Kanaya, Seiichiro;Nomura, Hajime;Kinjo, Yousuke;Tsubono, Michihiko;Kii, Eiji
    • Journal of Gastric Cancer
    • /
    • 제15권1호
    • /
    • pp.53-57
    • /
    • 2015
  • Laparoscopic distal gastrectomy has become widespread as a treatment for early gastric cancer in eastern Asia, but a standard method for setting the stomach transection line has not been established. Here we report a novel method of setting this line based on anatomical landmarks. At the start of the operation, two anatomical landmarks along the greater curvature of the stomach were marked with ink: the proximal landmark at the avascular area between the last branch of the short gastric artery and the first branch of the left gastroepiploic artery, and the distal landmark at the point of communication between the right and left gastroepiploic arteries. Just before specimen retrieval, the stomach was transected from the center of these two landmarks toward the lesser curvature. Then, about two-third of the stomach was reproducibly resected, and gastroduodenostomy was successfully performed in 26 consecutive cases. This novel method could be used as a standard technique for setting the transection line in laparoscopic distal gastrectomy.

종단면과 횡단면을 이용한 3차원 얼굴 인식 (3D Face Recognition using Longitudinal Section and Transection)

  • 이영학;박건우;이태홍
    • 한국정보과학회논문지:소프트웨어및응용
    • /
    • 제30권9호
    • /
    • pp.885-893
    • /
    • 2003
  • 본 논문은 3차원 얼굴영상으로부터 얼굴의 구성 요소 중의 하나인 코의 종단면과 횡단면을 이용한 특징값과 얼굴의 다를 구성 요소들로부터 구해진 특징값을 이용하여 얼굴을 인식하는 알고리듬을 제안한다. 객체와 배경을 분리하여 얼굴을 추출 및 얼굴의 최고점인 코끝을 찾은 후, 3차원 영상으로부터 얼굴의 주요 특징영역인 코 정보와 얼굴의 종단면 및 횡단면의 정보를 이용하여 회전 보상 전, 후의 특징값을 구한다. 코의 최고점, 코와 이마 사이의 미간점, 코의 밑점, 그리고 코의 앙쪽 끝점을 탐색하여 코의 종단면과 횡단면을 기준으로 한 면적, 깊이, 각도, 체적, 그리고 눈과 입의 간격을 특징값으로 사용하였다. 제안된 방법을 이용한 유사도 비교는 입력과 데이타 베이스에 대하여 각각 두 개의 깊이 데이타에 대해 유클리드 거리를 사용하였으며, 실험결과 임계 순위 값 5위 이내의 인식률이 95.5%로 나타났다.

Thoroughbred 망아지에서 단일나사못 장착 및 골막박리를 이용한 지세교정술 (A Case of New Surgical Correction of Angular Limb Deformities Using One Screw Implant & Periosteal Transection in a Thoroughbred Foal)

  • 양재혁;임윤규
    • 한국임상수의학회지
    • /
    • 제29권2호
    • /
    • pp.177-180
    • /
    • 2012
  • 다리기형(ALD)은 다리가 정중선에서 벗어나 측면으로 회전변형 된 것을 의미하고 망아지에 흔한 선천적 결손이다. 30일령의 Thoroughbred 망아지가 한국마사회 제주목장 동물병원으로 내원하였다. 방사선 검사에서 양 앞다리가 각각 외측으로 변형되었고 오른앞다리가 왼앞다리보다 심하게 회전된 것을 확인하여 단일나사고정술과 골막박리술을 이용하여 교정수술을 하였다. 40일 후 나사를 제거하였고 술부의 섬유화 및 과잉교정 등 합병증이 없이 바르게 교정되었다. 이 결과로 국내 신생망아지에 isoflurane을 이용한 흡입마취에서 단일나사고정술과 골막박리술은 안전하고 효과적인 수술임을 확인하였다.

Features of the Filum Terminale in Tethered Cord Syndrome with Focus on Pathology

  • Sim, Jungbo;Shim, Youngbo;Kim, Kyung Hyun;Kim, Seung-Ki;Lee, Ji Yeoun
    • Journal of Korean Neurosurgical Society
    • /
    • 제64권4호
    • /
    • pp.585-591
    • /
    • 2021
  • Objective : Filum transection is one of the most commonly performed operative procedure in pediatric neurosurgery. However, the clinical and pathological features as well as the surgical indication are not well-established. This study aimed to analyze the characteristics of patients who underwent transection of the filum during the last 10 years in a single institute. Methods : A total of 82 patients underwent transection of the filum during the period. As a general rule, we performed the transection in patients who are symptomatic or have abnormality in the urologic or neuromuscular evaluations. There were exceptions as asymptomatic patients who only fit the definition of thickened filum (width greater than 2.0 mm or conus level below L3 vertebral body) were operated by parent's wish or surgeon's preference according to radiological findings, etc. Results : Seventy-six out of 82 patients had fibrous tissue in the pathologic specimen of filum. Interestingly, patients who had glial cells were more correlated with no preoperative syrinx, and no progression of syrinx even for those who did have syrinx initially. Also, larger percentage of symptomatic patients had peripheral nerve twigs than asymptomatic patients. No difference in conus level or thickness of filum was found between patients with or without preoperative syrinx. Significantly more patients with syrinx (56%) were chosen to be operated without any symptom or abnormality in study i.e., solely based on radiological findings than those without syrinx (21%). The surgical outcome for syrinx was favorable, as all but one patient had either improved or static syrinx. The exceptional case had increase in size due to the upward displacement of the proximal end of the cut filum. Conclusion : This study evaluated the pathological, clinical, radiological features of patients who underwent transection of the filum. Interesting correlations between pathological findings and clinical features were found. Excellent outcome regarding preoperative syrinx was also shown.

단순결찰봉합술식을 이용한 외상성 대동맥완전파열의 치료 -2례 보고- (Primary Repair of Traumatic Aortic Transection with Clamp and Sew Technique -Report of 2 cases-)

  • 안지섭;박남희;최세영;박진상;박창권;이광숙;유영선
    • Journal of Chest Surgery
    • /
    • 제33권9호
    • /
    • pp.756-760
    • /
    • 2000
  • Traumatic aortic transection after blunt chest injury is highly lethal and has high operative mortality. Recently, the diagnostic and therapeutic method of this injury is advanced, especially in spinal cord protection during aortic cross-clamping. We have experienced two cases of traumatic aortic transection with left hemothorax after blunt chest injury, which was diagnosed in operative field. The transected aorta was primarily repaired with clamp and sew method and postoperative paraplegia had not occured. The patients were dischraged without any significant complications. We report these cases with a review of literature.

  • PDF

Total robotic right hepatectomy for multifocal hepatocellular carcinoma using vessel sealer

  • Peeyush Varshney;Vaibhav Kumar Varshney
    • 한국간담췌외과학회지
    • /
    • 제27권1호
    • /
    • pp.95-101
    • /
    • 2023
  • Rapid adoption of a robotic approach as a minimally invasive surgery tool has enabled surgeons to perform more complex hepatobiliary surgeries than conventional laparoscopic surgery. Although various types of liver resections have been performed robotically, parenchymal transection is challenging as commonly used instruments (Cavitron Ultrasonic Surgical Aspirator [CUSA] and Harmonic) lack articulation. Further, CUSA also requires a patient-side assistant surgeon with hepatobiliary laparoscopic skills. We present a case report of total robotic right hepatectomy for multifocal hepatocellular carcinoma in a 70-year-old male using 'Vessel Sealer' for parenchymal transection. Total operative time was 520 minutes with a blood loss of ~400 mL. There was no technical difficulty or instrument failure encountered during surgery. The patient was discharged on postoperative day five without any significant complications such as bile leak. Thus, Vessel Sealer, a fully articulating instrument intended to seal vessels and tissues up to 7 mm, can be a promising tool for parenchymal transection in a robotic surgery.