• Title/Summary/Keyword: Wada

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Language Lateralization in Patients with Temporal Lobe Epilepsy : A Comparison between Volumetric Analysis and the Wada Test

  • Oh, Young-Min;Koh, Eun-Jeong
    • Journal of Korean Neurosurgical Society
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    • 제45권6호
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    • pp.329-335
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    • 2009
  • Objective : Determining language lateralization is important for the presurgical evaluation of patients with medically intractable epilepsy. The Wada test has been the gold standard for lateralization of language dominance before epilepsy surgery. However, it is an invasive test with risk, and have some limitations. Methods : We compared the volumetric analysis with Wada test, and studied the clinical potential of volumetric analysis to assess language laterality in large surgical candidates with temporal lobe epilepsy (TLE). To examine the efficacy of volumetric analysis to determine language lateralization during presurgical evaluation, we compared the volumetric analysis of the bilateral planum temporale with the results of Wada test in 59 patients with chronic intractable TLE (rTLE, n=32; lTLE, n=27) who underwent epilepsy surgery. We measured the gray matter volumes of planum temporale (PT) of each patients using the VoxelPlus2 program (Mevisys, Daejeon, Korea). Results : Overall congruence of the volumetric analysis with the Wada test was 97.75% in rTLE patients and 81.5% in lTLE patients. There were more significant leftward asymmetry of the PT in rTLE patients than lTLE patients. In lTLE patients, relatively high proportion (37%) of the patients showed bilateral or right hemispheric language dominance. Conclusion : These results provide evidence that the volumetric analysis of the PT could be used as an alternatives in language lateralization. Also, the results of the Wada test suggested that there was considerable plasticity of language representation in the brains of patients with intractable TLE and it was associated with an earlier age of brain injury.

누두흉에 대한 외과적 치험 (Surgical Treatment of Funnel Chest)

  • 이종호;정승혁;김병열
    • Journal of Chest Surgery
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    • 제32권4호
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    • pp.399-403
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    • 1999
  • 배경: 누두흉은 가장 흔한 흉골기형으로 대부분이 선천적으로 흉골과 그 주위의 연골을 포함한 늑골의 일부가 함몰한 기형을 말한다. 누두흉의 수술방법은 Ravitch 술식에 의한 흉골거상법과 Wada 술식에 의한 흉골반전법이 주로 시행되어 왔다. 대상 및 방법: 1983년 1월부터 1996년 12월까지 누두흉의 수술적 교정을 받은 21명을 분석하였다. 환자의 연령별 분포와 동반된 기형의 종류, 동반된 증상, 각 수술방법에 따른 교정의 정도와 합병증의 유무, 환자의 술후 만족도를 조사하였다. 수술적 방법으로는 Wada술을 17례, Ravitch 술식을 4례 실시하였다. 수술적 적응증은 미용상의 이유가 가장 많았다. 결과: 술전의 Welch index는 평균 4.188 이었고 술후 3.46으로 개선되었고 Wada 술식에서 교정도가 높았다.(P=0.046) 합병증의 빈도는 Ravitch 변형술에서 높았으나 통계적 유의성은 없었다.(P=0.54) 수술후 합병증을 보인 1례를 제외한 전례에서 환자의 만족도, 술전의 정신,신체적 결함에서 회복되었고 함몰의 교정 정도에서도 만족할만한 결과를 얻었다. 수술후 외래 추적 결과 누두흉의 재발과 사망례는 없었다. 결론: 학동기전후연령과 함몰이 대칭성인 누두흉인 경우에서 흉골반전술이 좋은 술식이 된다고 생각한다.

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누두흉의 수술적 교정: 14례 보고 (Pectus excavatum and operative treatment: 14 cases report)

  • 선경;채성수;이철세;백광제;김학제;김형묵
    • Journal of Chest Surgery
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    • 제16권1호
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    • pp.183-190
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    • 1983
  • Pectus Excavatum is a congenital anomaly of the anterior chest wall with a sharp concave curvature of the body of the sternum, from above downward and from side to side, especially just before the junction of gladiolo-xiphoid. We have experienced 14 cases of Pectus Excavatum with several operative procedures, i.e., Ravitch operation in 1 case, Wada operation [Sternal turn-over} in 3 cases, Wada operation and K-wire splint in 5 cases, Modified Wada operation [Rectus Abdominis muscle pedicle attached sternal turn-over] in 5 cases. Nearly all patients developed flail chest treated with internal fixation, and necrotic chondritis was developed postoperatively and treated with excision and curettage in one case with Wada operation. Follow-up Vertebral Index showed 48% preoperatively and 33% postoperatively, average decrement of 15%. We report 14 cases of Pectus Excavatum and their operative treatments.

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Debridement Arthroplasty

  • Wada Takuro
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2002년도 아시아견관절학술대회
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    • pp.403-406
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    • 2002
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누두흉의 수술적 교정 (Surgical Repair of Pectus Excavatum)

  • 조덕곤
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.1027-1034
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    • 1990
  • Pectus excavatum, commonest developmental anomaly of chest wall, is manifested by depression of the sternum and lower costal cartilages that is of surgical interest. From 1982 through 1990, fifteen patients have undergone surgery for treatment of pectus excavatum and treated by Ravitch operation: 5, Modified Ravitch operation; 4, Wada operation, 1 and Modified Wada operation, 5. There was familial history of pectus excavatum in 3 patients. Associated congenital anomaly were seen in 6 patients; scoliosis in 3 patients, right inguinal hernia in 1, polydactyly in 1 and patent ductus arteriosus in 1 patent. Postoperative minor complications were developed in 3 cases; pneumothorax, 2 cases; pleural effusion, 2 cases; wound infection and dehiscence, 1 cases; pressure sore due to strut malposition, 2 cases; flail chest and 2 cases; seroma. The incidence of the postoperative complications were more common in cases who were treated by metal strut, pin or other prosthetic materials for supporting the chest wall integrity than the standard corrective procedure. All cases have no recurrence of chest wall depression and operative death.

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Comparison of the lateralization using the activation of the Brocas and the Wernickes area with that of total cortical activation amount of cerebral hemisphere in the functional MR for measuring language lateralization based on Wada test

  • Lee, Sang-Hyun;Chang, Kee-Hyun;Chung, Chun-Kee;Song, In-Chan;Han, Moon-Hee
    • 대한자기공명의과학회:학술대회논문집
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    • 대한자기공명의과학회 2001년도 제6차 학술대회 초록집
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    • pp.105-105
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    • 2001
  • Purpose: The activation of the Brocas and the Wernickes area in the language functional MR (fMR) well-known phenomena. We want to evaluate correlation of that activation with langua lateralization. So we evaluate the lateralization using the activation of the Brocas and t Wernickes area comparing with total cortical activation amount of cerebral hemisphere in t functional MR for measuring language lateralization based on Wada test.

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