• 제목/요약/키워드: perforating

검색결과 79건 처리시간 0.022초

팔 오금에서 시행한 관통정맥을 이용한 동정맥루 조성술의 임상적 고찰 (Clinical Analysis of Arteriovenous Fistula Using Perforating Vein on Antecubital Fossa)

  • 최광호;윤영철;이양행;조광현
    • Journal of Chest Surgery
    • /
    • 제43권6호
    • /
    • pp.642-647
    • /
    • 2010
  • 배경: 팔 오금에서 시행되는 위팔동맥과 자쪽 피부정맥이나 노쪽 피부정맥을 이용한 동정맥루 조성술 외에 관동정맥을 이용한 동정맥루 조성술을 시행하여 개통률 및 영향을 미치는 인자들을 조사, 분석하고자 한다. 대상 및 방법: 2006년 5월부터 2009년 12월까지 본원 흉부외과에서 팔오금에 동정맥루 조성술을 시행받은 192명 205예의 수술을 대상으로 후향적 조사를 실시하여 개통률 및 개통과의 연관성을 분석하였다. 결과: 관동정맥을 이용한 수술의 6개월, 1년, 2년 개통률은 75.91%, 60.79%, 37.80%으로 다른 혈관을 이용한 수술의 결과와 통계적으로 차이는 보이지 않았다. 여러 인자 중 연령에 따라 개통률에 차이를 보였다(p <0.001). 결론: 팔 오금에서 동정맥루 조성술이 필요한 환자에서는 관통정맥을 이용함으로써 노쪽 피부정맥과 자쪽 피부정맥을 사용할 수 있어 혈관의 접근 방법이 다양해지고 관통정맥의 해부학적 위치에 따라 술식의 어려움이 없어 수술 접근에 대한 추가적 대안이 될 수 있을 것이다.

내시경적 교통정맥 결찰술과 부분층 피부이식술로 치료한 정맥성 궤양의 치험례 (A case of venous stasis ulcer treated by subfascial endoscopic perforator ligation and split thickness skin graft)

  • 문성호;이종욱;고장휴;서동국;최재구;장영철
    • Archives of Plastic Surgery
    • /
    • 제36권3호
    • /
    • pp.336-340
    • /
    • 2009
  • Purpose: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg. Methods: A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations - the split thickness skin graft - at different clinics, the wound did not heal. The size of the wound was 12 by $8cm^2$ and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC$^{(R)}$ for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft. Results: Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications. Conclusion: Subfascial endoscopic perforator ligation is relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be valuable method for treating severe venous stasis ulcers.

Chondrocutaneous posterior auricular artery perforator free flap for single-stage reconstruction of the nasal tip: a case report

  • Lee, Jun Yong;Seo, Jeong Hwa;Jung, Sung-No;Seo, Bommie Florence
    • 대한두개안면성형외과학회지
    • /
    • 제22권6호
    • /
    • pp.337-340
    • /
    • 2021
  • Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at follow-up 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.

상악동 점막 천공부위로의 치아이식 (Autotransplantation of tooth into the oroantral fistula site after extraction)

  • 김영운
    • 대한치과의사협회지
    • /
    • 제41권7호통권410호
    • /
    • pp.504-508
    • /
    • 2003
  • This report demonstrates a case of tooth autotransplantation into the oroantral fistula site after extraction. Oroantral fistula can be developed when maxillary molar or premolar is extracted in case the root of tooth closed to or inside maxillary sinus. In most of cases, this would heal spontaneously without any interventions. Sometimes, many procedures including flap closure would be used judging from perforating size and previous inflammation. Although fistula size of this case is not that large, closure with tooth autotransplanted has successfully accomplished. So this report will discuss about several clinical aspects.

  • PDF

유한요소법을 이용한 머플러 튜브의 타공공정 성형해석

  • 황원식;김석대;한규택
    • 한국정밀공학회:학술대회논문집
    • /
    • 한국정밀공학회 2004년도 춘계학술대회 논문요약집
    • /
    • pp.268-268
    • /
    • 2004
  • 머플러는 소음의 저감과 공기 정화의 특성으로 인해 자동차와 중장비에 적용되고 있다 최근에는 강화되고 있는 엄격한 환경규제를 만족하기 위해 그 설계와 제조에 있어 그 중요성이 높아지고 있으며, 머플러 튜브의 형태와 타공의 개수 및 배열은 다양한 형태로 연구가 이루어지고 있다. 이 중에서 튜브의 타공은 차량의 중량과 기능에 따라 다양한 형태를 가지며, 모델수의 증가와 출시기간의 단축으로 인해 튜브의 타공기술은 머플러 시장의 경쟁력을 좌우할 정도로 중요해 지고 있다.(중략)

  • PDF

하지정맥류의 임상양상 - 227 수술예의 분석 - (Clinical Analysis of Varicose Veins in the Lower Extremities - an analysis of 227 operative cases -)

  • 최수승
    • Journal of Chest Surgery
    • /
    • 제32권11호
    • /
    • pp.1036-1041
    • /
    • 1999
  • Background: To know the clinical aspects of varicose vein and the effectiveness of operative treatment, the patients who had been operated during the five and a half years were reviewed. Material and Method: From September 1993 to February 1999, 227 patients with varicose vein were operated upon. These patients were reviewed with history taking, physical examination, laboratory tests, operation and follow up visits at an out patient department. Result: The ages of the patients were from 20 to 69 years, mean 40.2 years. varicose veins. Occupations of the patients include housewives, store or factory owners, cooks, waiter or waitresses in a restaurant, salary men(women), teachers, hair stylists, professional athletes, in sequence, most of them require standing all day long. The 126 women had experienced child birth, among them 116 patients delivered more than 2 babies. All patients had protruding leg veins as the symptom. Most of them(61%) had pain. Other additional symptoms were heaviness, heatness, tingling, cramp, fatigue, etc. 68.3% of the patients had the symptoms for more than 10 years. Anatomical location of varicose vein was in long saphenous vein in 157 patients, in small saphenous vein in 27, and in other regions(combined or perforating vein) in 43 patients. There was no operative mortality. There were 2 patients who underwent reoperation due to recurrence during this study period. In one patient, it recurred in the distal perforating vein in small saphenous vein. The other patient had recurrence at the saphenofemoral junction in groin. The patients are doing well after the reoperation, but a long term observation is needed. Conclusion: Clinical aspects of varicose vein were reviewed. For the patients with varicose vein who had saphenofemoral regurgitation, operative treatment seemed to bea safe and effective modality of treatment.

  • PDF

Development of an Ex Vivo Model for the Study of Cerebrovascular Function Utilizing Isolated Mouse Olfactory Artery

  • Lee, Hyung-Jin;Dietrich, Hans H.;Han, Byung Hee;Zipfel, Gregory J.
    • Journal of Korean Neurosurgical Society
    • /
    • 제57권1호
    • /
    • pp.1-5
    • /
    • 2015
  • Objective : Cerebral vessels, such as intracerebral perforating arterioles isolated from rat brain, have been widely used as an ex vivo model to study the cerebrovascular function associated with cerebrovascular disorders and the therapeutic effects of various pharmacological agents. These perforating arterioles, however, have demonstrated differences in the vascular architecture and reactivity compared with a larger leptomeningeal artery which has been commonly implicated in cerebrovascular disease. In this study, therefore, we developed the method for studying cerebrovascular function utilizing the olfactory artery isolated from the mouse brain. Methods : The olfactory artery (OA) was isolated from the C57/BL6 wild-type mouse brain. After removing connective tissues, one side of the isolated vessel segment (approximately $-500{\mu}m$ in length) was cannulated and the opposite end of the vessel was completely sealed while being viewed with an inverted microscope. After verifying the absence of pressure leakage, we examined the vascular reactivity to various vasoactive agents under the fixed intravascular pressure (60 mm Hg). Results : We found that the isolated mouse OAs were able to constrict in response to vasoconstrictors, including KCl, phenylephrine, endothelin-1, and prostaglandin $PGH_2$. Moreover, this isolated vessel demonstrated vasodilation in a dose-dependent manner when vasodilatory agents, acetylcholine and bradykinin, were applied. Conclusion : Our findings suggest that the isolated olfactory artery would provide as a useful ex vivo model to study the molecular and cellular mechanisms of vascular function underlying cerebrovascular disorders and the direct effects of such disease-modifying pathways on cerebrovascular function utilizing pharmacological agents and genetically modified mouse models.

Hydraulic fracturing experiments of highly deviated well with oriented perforation technique

  • Zhu, Hai Y.;Deng, Jin G.;Liu, Shu J.;Wen, Min;Peng, Cheng Y.;Li, Ji R.;Chen, Zi J.;Hu, Lian B.;Lin, Hai;Guang, Dong
    • Geomechanics and Engineering
    • /
    • 제6권2호
    • /
    • pp.153-172
    • /
    • 2014
  • In order to investigate the effect of different perforation angles (the angle between the perforation direction and the maximum horizontal principal stress) on the fracture initiation and propagation during hydraulic fracturing of highly deviated well in oil & gas saturated formation, laboratory experiments of the hydraulic fracturing had been carried out on the basis of non-dimensional similar criteria by using 400^3 $mm^3$ cement cubes. A plane fracture can be produced when the perforations are placed in the direction of the maximum horizontal principal stress. When the perforation angle is $45^{\circ}$, the fractures firstly initiate from the perforations at the upper side of the wellbore, and then turn to the maximum horizontal principal stress direction. When the well deviation angle and perforation angle are both between $45^{\circ}$ and $90^{\circ}$, the fractures hardly initiate from the perforations at the lower side of the wellbore. Well azimuth (the angle between the wellbore axis and the maximum horizontal principal stress) has a little influence on the fracture geometries; however it mainly increases the fracture roughness, fracture continuity and the number of secondary fractures, and also increases the fracture initiation and propagation pressure. Oriented perforating technology should be applied in highly deviated well to obtain a single plane fracture. If the well deviation angle is smaller, the fractures may link up.

Successful Obliteration of Unclippable Large and Giant Middle Cerebral Artery Aneurysms Following Extracranial-Intracranial Bypass and Distal Clip Application

  • Yoon, Won-Ki;Jung, Young-Jin;Ahn, Jae-Sung;Kwun, Byung-Duk
    • Journal of Korean Neurosurgical Society
    • /
    • 제48권3호
    • /
    • pp.259-262
    • /
    • 2010
  • Large to giant middle cerebral artery aneurysm is a challenging disease, especially when incorporating important perforating arteries. Surgical risk increases by perforator infarction and anatomical complexity. In this clinical setting, extensive consideration of surgical options is needed. The two cases described here were unruptured and had rather stable wall. Because of their large and giant size, hardness and incorporated arteries, it was not affordable to isolate them by means of clipping or trapping. The procedure as the alternative to conventional treatment modalities, extracranial-intracranial bypass followed by clipping of only the efferent artery successfully treated the aneurysms.

Mammary Gland Adenocarcinoma in a Mandrill

  • Lee, Jung-Keun;Park, Ja-Hoon;Shin, Nam-Sik;Kwon, Soo-Wahn;Lee, Ki-Whan;Kim, Dae-Yong
    • 한국수의병리학회:학술대회논문집
    • /
    • 한국수의병리학회 2000년도 추계학술대회 및 정기총회
    • /
    • pp.24-24
    • /
    • 2000
  • A case of mammary gland adenocarcinoma is reported in a 22-year-old female Mandril (Mandrillus sphinix). The veterinarian noted a fast growing mass, which was inflammed and perforated, involving both mammary gland during the last 4 months. Supplement antibiotic and chemotherpay were unsucessful and the monkey was found dead. On necropsy, both right and left mannary gland were replaced by firm, tan, perforating neoplastic mass. (omitted)

  • PDF