• 제목/요약/키워드: anatomical location

검색결과 244건 처리시간 0.027초

급성 또는 재발성 슬개골 탈구의 치료에 있어서 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술 - 수술 술기 - (Arthroscopic Medial Plication using Pull-out Suture for the Treatment of Acute or Recurrent Patellar Dislocation - Technical Note -)

  • 안진환;김재훈;하해찬
    • 대한관절경학회지
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    • 제10권2호
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    • pp.214-218
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    • 2006
  • 목적: 급성 또는 재발성 슬개골 탈구의 치료에 있어서 내측 슬개-대퇴 인대의 해부학적 위치를 고려하여 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술을 새롭게 고안하였기에 소개하고자 한다. 수술 술기: 관절경하에서 내측 슬개-대퇴 인대가 위치하는 부위의 내측 관절막에 봉합사를 관절 밖에서 안으로 통과시킨다. 슬개골에 유도강선으로 3개의 터널을 뚫는데, 그 관절내 입구가 슬개골의 내측 변연 상부 1/2에 위치하도록 한다. 관절 내로 들어와 있는 봉합사를 슬개골의 터널을 통해 관절 밖으로 빼내고, 봉합사에 긴장을 준 상태에서 적절한 정도로 외측 지대 유리술을 시행한 후 봉합사를 결찰한다. 결론: 본 술기는 최근 중요시되고 있는 내측 슬개-대퇴 인대를 봉합함으로써 내측 관절막 중첩술의 효과를 극대화시키고 슬개골의 아탈구 및 경사를 교정할 수 있으며, 최소 침습적이고 비교적 쉽고 간단하여 급성 또는 재발성 슬개골 탈구의 치료에 있어서 효과적인 술식으로 생각된다.

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Social Determinants of Health and 5-year Survival of Colorectal Cancer

  • Heidarnia, Mohammad Ali;Monfared, Esmat Davoudi;Akbari, Mohammad Esmail;Yavari, Parvin;Amanpour, Farzaneh;Mohseni, Maryam
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5111-5116
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    • 2013
  • Background: Early in the 21st century, cancers are the second cause of death worldwide. Colon cancer is third most common cancer and one of the few amenable to early diagnosis and treatment. Evaluation of factors affecting this cancer is important to increase survival time. Some of these factors affecting all diseases including cancer are social determinants of health. According to the importance of this disease and relation with these factors, this study was conducted to assess the relationship between social determinants of health and colon cancer survival. Materials and Methods: This was a cross-sectional, descriptive study for patients with colon cancer registered in the Cancer Research Center of Shahid Beheshti University of Medical Science, from April 2005 to November 2006, performed using questionnaires filled by telephone interview with patients (if patients had died, with family members). Data was analyzed with SPSS software (version 19) for descriptive analysis and STATA software for survival analysis including log rank test and three step Cox Proportional Hazard regression. Results: Five hundred fifty nine patients with ages ranging from 23 to 88 years with mean${\pm}$standard deviation of $63{\pm}11.8$ years were included in the study. The five year survival was 68.3%( 387 patients were alive and 172 patients were dead by the end of the study). The Cox proportional hazard regression showed 5-year survival was related to age (HR=0.53, p=0.042 for>50 years versus<50 years old) in first step, gender (HR=0.60, p=0.006 for female versus male) in second step, job (HR=1.7, p=0.001 for manual versus non manual jobs), region of residency (HR=3.49, p=0.018 for west versus south regions), parents in childhood (HR=2.87, p=0.012 for having both parents versus not having), anatomical cancer location (HR=2.16, p<0.033 for colon versus rectal cancer) and complete treatment (HR=5.96, p<0.001 for incomplete versus complete treatment). Conclusions: Social determinants of health such as job, city region residency and having parents during childhood have significant effects in 5-year survival of colon cancer and it may be better to consider these factors in addition to developing cancer treatment and to focus on these determinants of health in long-time planning.

Retrospective Study of Cysts in the Oral and Maxillofacial Regions: Statistical and Clinical Analysis

  • Lee, Hyun-Kyung;Ryu, Kyung-Sun;Kim, Moo-Gun;Park, Kwang-Won;Kim, Ryun-Ga;Roh, Sang-Hwa;Jung, Tae-Young;Park, Sang-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제36권1호
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    • pp.1-6
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    • 2014
  • Purpose: This study was designed for identification of the main clinicopathological features of cysts in the oral and maxillofacial regions. Methods: A retrospective observational study was conducted on 164 patients who had been diagnosed with cyst of the jaw, from the database of 168 histopathological diagnoses at the Department of Oral and Maxillofacial Surgery of Busan Paik Hospital at Inje University, from January 2009 to December 2011. The subjects were treated and the following variables were recorded: gender, age, clinical signs and symptoms, histopathological distribution, treatment methods, and complications. A descriptive analysis of the study variables was performed using a chi-square test. Results: Among the 164 patients, there were more male than female patients (male-female ratio: 1.7:1). The most predominant ages were the 20s and 40s. Among the classes of pathological cysts, radicular cysts and dentigerous cysts were the most common, with incidences of 56.0% and 35.1%. Thirty-six percent of the patients had no symptoms; and of those who had symptoms, the main signs and symptoms were swelling (24.4%) and pain (17.1%). The most frequent management method was the combination operation, such as enucleation with or without extraction and apicoectomy of the causative teeth. Of the 164 patients, 13 had complications; and one patient who had been treated with enucleation with apicoectomy had a recurrent cyst. Conclusion: Using a chi-square test, no significant differences in prevalence were observed in relation to gender according to age. Comparative analysis of radicular and dentigerous cysts showed a significant difference in their prevalence according to their anatomical location, however, no significant differences in were observed in their incidence rates according to age.

경골 천정(pilon) 골절의 최신 치료 (Current Treatment of Tibial Pilon Fractures)

  • 이준영
    • 대한족부족관절학회지
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    • 제15권2호
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    • pp.51-57
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    • 2011
  • Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.

잔여 하정맥동형 심방중격결손증의 재수술 (Reoperation for the Missed Inferior Sinus Venous Atrial Septal Defect)

  • 유병수;조태준;김건일;이재웅;홍기우;이원용
    • Journal of Chest Surgery
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    • 제39권2호
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    • pp.154-156
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    • 2006
  • 난원와 하부에 위치하는 하정 맥동형 심방중격결손증(inferior sinus venclsus defect)은 매우 드문 선천성심질환으로 수술 전 이차공형 심방중격결손증과 감별이 어렵고 수술 중에도 발견하기가 쉽지 않다. 저자들은 10세 때에 심방중격결손증으로 단순 봉합술 시행 후 별 문제없이 지내다가 이비인후과 수술 위한 사전 검사로 시행한 심장초음파 검사상 잔여 심방중격결손증이 발견된 24세 여자 환자에서 심방중격결손증 재수술을 시행하였다. 환자는 이차공형 심방중격결손증과 하정맥동형 심방중격결손증을 동시에 가지고 있었으나 일차수술에서 하정맥동형 심방중격결손증을 발견하지 못하여 이차공형 심방중격결손증만 교정된 상태였고, 금번 재수술에서 하정맥동형 심방중격결손증을 확인하고 패취 봉합을 시행하였다.

한국인에 있어 깊은아래배벽동맥(Deep Inferior Epigastric Artery)의 천공지(Perforator)에 관한 해부학적 연구 (Anatomical Study for Vascular Distribution of the Perforator of Deep Inferior Epigastric Artery in Koreans)

  • 김지훈;이백권;이종원;김덕임;한승호
    • Archives of Plastic Surgery
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    • 제35권1호
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    • pp.28-35
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    • 2008
  • Purpose: The pedicle of transverse rectus abdominis myocutaneous(TRAM) flap and deep inferior epigastric arterial perforator flap is deep inferior epigastic artery (DIEA) and accurate anatomic knowledge about perforator of DIEA is very important for the elevation of these flap. The authors investigated a detailed vascular network of perforator of DIEA in Koreans. Methods: 24 fresh cadavers were studied. Among them, 15 were examined based on the plain X-ray examination for the distribution and location of perforator of DIEA. And 9 fresh cadavers were examined based on the 3-dimensional computed tomography(CT) study for the distance between ending point of perforator of DIEA and mother artery, the distance between most medial mother artery and midline, the distance between most lateral mother artery and midline, and the running type of perforators of DIEA. Results: Based on the plain X-ray examination, suitable(external diameter$${\geq_-}0.5mm$$) perforators of DIEA are located between the level of umbilicus and 8 cm below it. Based on the 3D-CT study, average distance between the ending point of perforator of DIEA and the mother artery is 30.26 mm on the left, 28.62 mm on the right, respectively. The average distance between most medial mother artery and midline is 17.13 mm on the left, 15.76 mm on the right, respectively. The average distance between most lateral mother artery and midline is 56.31 mm on the left, 50.90 mm on the right, respectively. The main running course of suitable perforators of DIEA is type a, which is a direct musculocutaneous perforator vessel from main vascular axis passing outward to join the subdermal plexus, directly. Conclusion: 3-dimensional computed tomography study as well as plain X-ray examination provided more accurate and detail informations about perforators of DIEA in Koreans. These informations will help us understand the detailed vascular anatomy and operation with ease and safe in the lower abdomen of Koreans.

상악동 중격의 발생율과 파노라마 방사선 사진의 정확도 (INCIDENCE OF SINUS SEPTA AND ACCURACY OF PANORAMIC RADIOGRAPH)

  • 신창훈;김형진;홍종락;양승민
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권5호
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    • pp.504-510
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    • 2007
  • Purpose: The purpose of this study was to determine the incidence of antral septa and the accuracy of panoramic radiograph in identifying maxillary sinus septa. In addition, when panoramic radiograph led to a false diagnosis of more than majority, we analyzed findings of the panoramic radiograph. Patients and methods: This study included 180 patients who were radiographically examined before the surgery was done using both panoramic and computerized tomographic radiographs(CT scan), Samsung Medical Center from April 2003 to March 2006, and examined the incidence of antral septa, the false diagnosis rate of panoramic radiograph, and radiographic characters in case of false diagnosis. Only those bone lamellae were considered as septa that showed a height of at least 3.0mm. It was thus possible to exclude the alveolar recess. One oral and maxillofacial surgeon(OMFS) determined the presence or absence of sinus septa in CT scan, and five OMFS determined the presence or absence of sinus septa in panoramic radiograph. Results: The septa were observed in 81 of 360 sinuses(22.5%). All septa were oriented in a buccopalatal plane. More or less greater prevalence was observed in the second molar region(38.2%) but no predominant location was found. Panoramic radiograph led to false diagnosed septa in 361 of 1800 cases(20.1%). In case of false diagnosis of more than majority, superimposed image on zygomatic process was 44.1%, faint image in the region not related to sinus lifting 26.5%, faint image in the region related to sinus lifting 17.6%, and misconception for superimposed image 11.8% Conclusion: In this study we could get clinico-anatomical information of septum in the maxillary sinus. Compared to CT scan, panoramic radiograph can not clearly differentiate the sinus septa, but we consider that panoramic radiograph may improve its usefulness if we take additional modified panoramic radiograph and clinical exam.

하악 제1대구치에서 Radix Entomolaris의 발현빈도와 치근의 개수에 따른 근관 입구들 사이의 위치 관계에 대한 연구 (A study on Radix Entomolaris about prevalence and correlation of canal orifices location according to number of roots in mandibular first molars)

  • 장지혜;김진우;조경모;김수연;박세희
    • 대한치과의사협회지
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    • 제56권12호
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    • pp.695-706
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    • 2018
  • Objectives: The purpose of this study was to investigate the ratio of 4 root canals and the incidence of Radix Entomolaris in mandibular first molars and find out anatomical difference according to number of roots by analysis of cone-beam CT images in a Korean population. Materials and Methods: Total 142 images containing mandibular first molars were selected from CBCT images taken from 2013 to 2017 at Gangneung-Wonju National University Dental Hospital. After reconstructing the image with reference to the Cemento-enamel junction, the root canals were detected at the bottom of the pulpal floor and the number of roots and root canals were analyzed. Various lengths and MLO-DLO-DBO angle were measured between each canal orifices and the external contour line of the tooth, and the distolingual canal wall thickness was measured. Student t-test was used for statistical significance. Results: Among the total 142 teeth, 4 canals were 42.2% and Radix Entomolaris was 25.3%. As the results of measuring various lengths and the angle, the distolingual canal orifice in Group 2(with Radix Entomolaris) tends to deviate to the lingual side than the mesiolingual canal orifice and to the mesial side than the distobuccal canal orifice. Besides, thickness of the distolingual canal wall in Group 2(with Radix Entomolaris) was significantly thinner than that of Group 1 at every level except pulpal floor level. Conclusion: It is necessary to consider the difference according to the presence of Radix Entomolaris in endodontic treatment.

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소아 요골 원위부 불안정 골절의 캐스트 후 안정성에 영향을 미치는 요소 (Risk Factors in Stability after Immobilization of the Distal Radius in Unstable Fractures in Children)

  • 신용운;손종민;박상윤
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.215-223
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    • 2021
  • 목적: 소아 요골 원위부 골절은 가장 흔한 골절이면서 불안정 골절의 경우 정복 후에도 재전위 위험성이 높아 주의가 요망된다. 이러한 재전위에 영향을 미치는 요인들에 대하여 평가해 보고자 한다. 대상 및 방법: 2011년 2월부터 2018년 6월까지 완전 전위된 소아 요골 원위부 불안정 골절로 본원 외래에서 보존적 치료한 6세에서 14세까지의 환자들을 대상으로 후향적 연구를 하였다. 전체 대상 환자 44예 중 재전위된 환자들에서 연령, 성별, 석고 지표, 간격 지표, 3점 고정 지표, 골절면 경사도, 관절면에서 골절선까지 거리를 환산한 골절 높이 비, 요골-제2 중수골 각도 등을 측정하여 마지막 골유합 상태에서 남은 각형성의 정도로 결과를 평가하여 비교를 하였다. 결과: 평균 9.2도(0-32.8도) 각형성이 남았으며 범주 내의 결과를 기준으로 하여 10도 미만이 29예, 10도 이상이 15예로 확인되었다. 정복 후 재전위가 발생한 군과 대조군 사이에 평가된 요소들 중 석고 지표들은 두 군 간에 차이가 없었다. 연령, 성별에서도 군 간에 차이가 없었고, 골절면 경사도, 요골-제2 중수골 각도도 차이가 없었다. 관절면에서 골절선까지의 거리를 환산한 골절 높이 비가 가장 의미 있는 안정요소로 평가되었고(p=0.001) 척골 골절이 동반된 경우도 불안정한 요소로 평가되었다(p=0.019). 결론: 소아 요골 간단부 완전 전위 골절, 특히 요골 골간단-골간 이행부의 골절의 경우 불안정한 골절로 평가되므로 좀 더 주의가 필요하며 충분한 재형성을 기대하기 어려운 연령에서는 만족스러운 결과를 위하여 수술적 치료가 선호될 수 있다.

차세대염기서열분석 데이터 기반으로 선별한 전복(Haliotis discus hannai) 유래 신규 펩타이드의 항암 효과 (Anticancer Effect of Novel Peptide from Abalone (Haliotis discus hannai) based on Next Generation Sequencing Data)

  • 문현혜;황보전;비라판 칼파감;사티시쿠마 나타라잔;정호용;박준형
    • 한국해양생명과학회지
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    • 제7권1호
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    • pp.15-20
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    • 2022
  • 본 연구는 우리나라 해안에서 널리 서식 중인 해양 자원 중 하나인 전복(Haliotis discus hannai)의 차세대염기서열분석 데이터 기반으로 선별한 신규 펩타이드의 항암 활성을 평가한 연구이다. 펩타이드의 항암 활성은 교모세포종 세포주인 SNU-489에서 농도 의존적으로 처리 시간에 비례하여 증가하였으며, 200 µM로 48시간 처리하였을 때 암 세포 사멸율이 67%로 가장 높게 나타났다. 반면 정상 세포인 HaCaT에서 가장 높은 세포 사멸율은 18%로 농도 의존적이었으나 처리 시간과는 무관하였다. 또한 신규 펩타이드의 항암 메커니즘 과정을 밝히기 위해 세포자멸괴사(Necroptosis) 관련 유전자의 발현 변화를 qRT-PCR 방법을 통해 검증하였다. RIPK3는 신규 펩타이드 처리군에서 200 µM 처리 시 9배 이상 발현 증가, MLKL는 100 µM 처리군에서 대조군 대비 2배 이상 유의미하게 발현이 증가되었다. 이러한 결과로 미루어 볼 때, 전복 유래 신규 펩타이드는 암 세포 특이적으로 세포 독성을 가지며, 세포자멸괴사 메커니즘을 통해 암세포 사멸을 일으키는 것으로 추측되므로 신규 펩타이드가 추후 교모세포종 치료제의 후보 물질로 활용될 수 있을 것으로 사료된다.