• 제목/요약/키워드: physical dissection

검색결과 39건 처리시간 0.021초

Surgical Removal of the Lung Lobe Metal Foreign Body in a Dog

  • Hwang, Yawon;Kang, Jihoun;Chang, Dongwoo;Kim, Gonhyung
    • 한국임상수의학회지
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    • 제34권2호
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    • pp.108-111
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    • 2017
  • A 4-year-old, weighing 7.6 kg, castrated male, Pug presented with ingestion of gastric cavity foreign body. Physical examination revealed panting, retching and hyper-salivation. Blood chemistry and complete blood cell count were normal, but hypophosphatemia was observed. An abdominal radiograph revealed the foreign body (FB), round shape and 2 cm length, at the pyloric region of stomach. A thoracic radiograph revealed an incidental metal FB, 3.5 cm length, at the cranial portion of the diaphragm. An upper gastrointestinal endoscopy was performed to remove the FB in the stomach and then a peach-pit was removed. However the metal FB was not found in the esophagus therefore a lateral thoracotomy was performed. A right lateral thoracotomy through the $7^{th}$ intercostal space was accomplished to expose the right caudal lung lobe. After open the thoracic cavity, foreign body was not observed by gross evaluation and caudal lung lobe was attached to the diaphragm. The FB was identified inside the lung lobe and surrounded by granulation tissue. The metal FB (sewing needle) was removed with blunt dissection and incised lung lobe was sutured using absorbable suture material PDS 4-0 with interrupted suture. A thoracotomy tube was inserted into the thoracic cavity during surgery. Patient's respiration became stable after surgery. A chest tube was removed 3 days after surgery. No complications were noted and the dog was discharged 4 days after surgery. In small animal, foreign body ingestion is a common reason for emergency. After ingestion of the FB, perforation through the esophagus and migration to inside the lung lobe is not common in small animals. In this case, thoracic metal FB was identified incidentally and removal of a thoracic FB with thoracotomy was performed successfully.

Evaluation of improved transvenous heartworm extraction brush in dogs with caval syndrome

  • Jihyun Kim;Junemoe Jeong ;Kanghyo Park ;Kyoungin Shin ;In Sung Jang ;Hakyoung Yoon
    • Journal of Veterinary Science
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    • 제24권4호
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    • pp.46.1-46.12
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    • 2023
  • Background: Heartworm infection in dogs is caused by Dirofilaria immitis and common in shelter animals and outdoors dogs. Caval syndrome can develop with severe infection and physical heartworm removal is essential with heartworm burdens. In this study, we used an improved transvenous heartworm extraction brush, which was expected to cause less cardiovascular damage and allow easier manipulation. Objectives: This study aims to evaluate efficacy of this improved transvenous heartworm extraction brush. Methods: The brush was designed to improve upon the limitations of the previous brush-type devices. The brush was made of a polyvinyl chloride tube and threads of polyamides or polyglyconates. Metal material was inserted at the front tip for easy visualization under fluoroscopy. The eight dogs diagnosed with caval syndrome with large numbers of heartworms and pulmonary hypertension were used in this study. The removal procedure began with the dissection of the subcutaneous tissue around the right jugular vein. The device was inserted through the jugular vein. After insertion, the tube was rotated to catch the heartworms and extracted with the heartworms hanging on the threads. The procedure was repeated several times. Lastly, jugular vein and skin sutures were made. Adulticidal therapy was administered after heartworm removal. Results: The mean number of removed heartworms was 10.5 ± 4.24 and mean number of remaining heartworms was 0.63 ± 1.06. Total procedure time was 72.63 ± 51.36. Except for three cases, heartworms were not detected on ultrasonography after the procedure. No procedure-related side effects were observed within the 1- to 2-mon. Conclusions: An improved transvenous heartworm extraction brush is efficient for heartworm removal in dogs with caval syndrome.

양측 하악지 시상골 절단술 후 발생한 안면 신경 마비의 증례 (Facial Nerve Palsy after Bilateral Sagittal Split Ramus Osteotomy: Case Report)

  • 진수영;김수관;김학균;문성용;오지수;정경인;전우진;윤대웅;양석진
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권3호
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    • pp.276-280
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    • 2011
  • BSSRO (bilateral sagittal split ramus osteotomy) is an effective surgical method for maxillofacial deformities. Rigid fixation using a plate and screws can stabilize bony segments and induce early mouth opening. Though this procedure has a low complication rate, normal function and esthetic recovery is achieved through proper and early management of the complications. Complications consisting of temporomandibular disorders, sensory disturbances due to inferior alveolar nerve damage, open bite, malunion or nonunion, and facial nerve palsy occur, but these rarely develop. Facial nerve palsy causes the muscles involved in facial expression to depress, which results in ocular dryness or retinal damage. When facial nerve palsy develops, early management involving steroid medication and physical therapy is effective. In the case of severe damage, surgical intervention should be considered. A 20-year-male patient came to the oral and maxillofacial surgery department for orthognathic surgery. The mandible was set back by BSSRO under general anesthesia. Facial nerve palsy was observed on the left side of the face: steroid and vitamins were administered early and physical therapy was performed daily. These forms of management can aid in function and allow for gradual esthetic recovery. Presumed causes were excessive soft tissue retraction or soft tissue injury by the osteotome at the horizontal osteotomy of the ramus. Careful dissection, retraction and a precise osteotomy are needed for protection of the facial nerve. If nerve damage is observed, early management can help in the recovery of facial nerve function and esthetics.

악하선 암의 치료성적과 예후인자 (A Treatment Outcomes and Prognostic Factors of Malignant Submandibular Gland Tumor)

  • 임치영;남기현;이잔디;장항석;정웅윤;차인호;이창걸;최은창;박정수
    • 대한두경부종양학회지
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    • 제21권2호
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    • pp.201-207
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    • 2005
  • Purpose: Submandibular gland tumor is rare, less than 6% of head and neck tumor. The purpose of this article is to analysis the clinical experience and treatment outcomes of malignant submandibular gland tumor, suggesting a guideline of management. Methods: We retrospectively evaluated 26 patients who underwent operation for malignant submandibular gland tumor at Severence hospital between 1986 and 2004. Statistical analysis was performed by Kaplan-Meier method, log rank test, Chi-square test, Fisher's exact test using SPSS v12.0 for Windows. Results: They consisted of 18 males and 8 females whose median age was 47 years(range: 20-71). 10 cases of adenocystic carcinoma, 8 cases of carcinoma ex pleomorphic adenoma, 4 cases of mucoepidermoid carcinoma, 1 case each for acinic cell carcinoma, undifferentiated carcinoma, adeno carcinoma, epithelioid hemangioendothelioma. Sialoadenectomy only was performed in 10 cases(36.5%) and sialoadenectomy with neck node dissection was performed in 16 cases(63.5%). Adjuvant radiotherapy was done in 22 cases(84.6%). 10 year disease free survival rate for malignant submandibular gland tumor was 63.1 % and 10 year overall survival rate for malignant submandibular gland tumor was 70.1%. In univariate analysis, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. Conclusion: In this study, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. To prevent recurrence and to improve survival, early diagnosis and aggressive surgery must be considered.

대동맥-대정맥루 -치험 1예- (Aortocaval Fistula - A case report -)

  • 조광현;권영민;한일용;전희재;이양행;황윤호;윤영철
    • Journal of Chest Surgery
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    • 제38권10호
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    • pp.721-724
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    • 2005
  • 대동맥-대정맥 누공은 복부 대동맥류의 $1\%$ 이하에서 발생하는 희귀한 합병증 중 하나이다. 오랜 기간 동안 고혈압과 복부 대동맥류 병력을 가진 64세 남자 환자가 흉통, 호흡곤란, 상복부 불쾌감 그리고 박동성 복부 종괴를 주소로 내원하였다. 이학적 검사상 수축기 혈압이 70mmHg로 저혈압을 보였고, 복부에서는 박동성 종괴가 촉지되었고, 지속성 기계 잡음이 청진되었다. 검사실 소견으로는 혈색소(11.0 g/dL), BUN (5 mg/dL), creatine $(2.6\;mg\%)$이었고, 복부 전산화 혈관 촬영 결과, 10cm 크기의 신장하복부대동맥류와 복부 대동맥류와 대정맥을 연결하는 대동맥-대정맥 누공이 형성되어 확장된 대정맥 소견을 보여 응급 수술을 계획하였다. 대동맥류를 절개하고 혈전 제거 후, 1cm크기의 대동맥-대정맥 누공이 발견되었다. 대동맥-대정맥 누공은 도뇨관 풍선 확장술을 이용하여 지혈하였고, 대동맥류 밖에서 누공은 단순 지속 문합으로 봉합하였다. 대동맥-양측 장골동맥 이식편을 이용하여 대동맥류에 대한 수술을 마무리하였다. 환자는 수술 후 특별한 문제없이 퇴원하였다.

지방섬유성 과오종 : 증례보고 (Two Cases of Lipofibromatous Hamartoma)

  • 김남중;박은수;최환준;신호성;정성균;이영만
    • Archives of Plastic Surgery
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    • 제36권3호
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    • pp.356-360
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    • 2009
  • Purpose: Lipofibromatous Hamartoma(LFH) of nerve is a tumor - like lipomatous process principally involving the young persons. This is rare disease characterized by a soft slowly growing mass surrounding and infiltrating major nerves and their branches of the palm and digits. LFH of nerve usually affects the median nerve, with the most common sites of presentation being the distal forearm and hand in the wrist or palm. It may cause symptoms of compression neuropathy and is associated with macrodactyly. Recently, MRI plays a major role in confirming the diagnosis of LFH. Therefore, we present two cases of LFH in the hand with MRI features and surgical management. Methods: One is 6 - years - old female who presented with macrodactyly involving both the soft tissue and bony parts of the second, third and forth digits of her right hand. The other one is 16 - years - old man who presented involving the soft tissue of the second and third digits of his right hand, with pain and numbness, along with motor and sensory deficits in the median nerve distribution. To evaluation about LFH, we enforced preoperative MRI and physical examination. After confirming the diagnosis of LFH, we proposed decompression of all compromised peripheral nerve to help alleviate pain and paresthesia to reduce the likelihood of permanent motor and sensory sequelae. Results: A characteristic feature on MRI is the appearance of serpentiform nerve fascicle surrounded by fibro - fatty tissue within the expended nerve sheet. Distribution of fat between fascicles is asymmetric. Two cases were treated by limited debulking of the redundant tumor tissue and excision of epineurial fatty tissue. These cases were performed with relief of symptom. Conclusion: MRI not only confirms the diagnosis, it also provides a detailed assessment of nerve involvement preoperatively. Especially, on coronal images, the nerve has a spagetti - like appearance that is pathognomonic of LFH. Recommendations for early treatment include decompression of the carpal tunnel, debulking of the fibro - fatty sheath, microsurgical dissection of the neural elements and excision of involve nerve with or without grafting.

아랫입술에 생긴 선천성 샛길 증례 (A Case of Congenital Midline Fistula of the Lower Lip)

  • 최환준;최임돈;최창용;김숙;김용배
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.73-76
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    • 2011
  • Purpose: Congenital midline upper lip sinus is a rare lesion. There are two postulates that can account for the formation of the upper lip sinus based on two major theories of the development of the face: the fusion theory and the merging theory. However, congenital midline lower lip sinus is very rarely reported and described. We report a case of a congenital midline sinus of the lower lip in a 6-year-old female. Methods: A 6-year-old girl presented with a nipple like swelling on the midline lower lip. Physical examination revealed about $5{\times}5$ mm protruding round mass with a just small opening that was non-tender to palpation. The mass was not associated with any skin changes. It umbilicated at the apex and contains a fistulous tract, discharging clear fluid. Only, simple radiologic finding shows bony spur on the lower one third of mandibular symphsis. Results: A small transverse ellipse is made around the opening and elevated mass with sharpe dissection. The tract is excised using the probe and dye as the guide. The tract was extended to periosteum of the lower one third of the mandible. The tract and involved periosteum were excised en bloc, and removed protrusion of the mandibular bone using diamond burr. Microscopic examination of the resected sinus revealed the fistulous tract itself, consisting of fibrous connective tissue covered with cornified stratified squamous epithelium, was observed in the center of the sample. In 6 months follow-up, This patient had a good result was obtained by the method of fistulectomy alone. Conclusion: Midline cranoifacial fistulas represent rare lesions resulting from abnormal fusion of embryologic structures. Our case report describes the excision of a congenital midline sinus of the lower lip in a 6-year-old female. This case represents the first report of a lower lip sinus presenting in a girl as a mass in the skin of the chin with extension to the midline of the mandible. However, the etiology of this rare congenital sinus remains obscure.

광개시제, 올리고머 그리고 Talc 함량에 따른 아크릴계 코팅제의 UV경화 및 박리특성 (UV Curing and Peeling Characteristics of Acrylic Coating Ink with Various Amounts of Photoinitiator, Oligomer and Talc)

  • 양지우;서아영;이철우
    • 공업화학
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    • 제24권5호
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    • pp.499-506
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    • 2013
  • 전자 통신 산업의 발달로 터치 패널용 강화유리의 사용량이 급격히 증가함에 따라, 판유리 가공 공정 중 유리표면을 보호하기 위한 용도로 사용되는 UV경화형 코팅용액의 사용량이 함께 증가하고 있다. UV경화형 코팅은 열경화형에 비해 경화시간이 매우 짧고, 용제를 사용하지 않는 장점이 있다. 알칼리에 의한 박리 특성을 부여하기 위해 산성 고분자 styrene-acrylic acid copolymer를, 모노머로는 아크릴기가 각각 1개, 2개, 6개인 2-hydroxyl methylacrylate, 1,6-hexanediol diacrylate 그리고 dipentaerythritol hexaacrylate를 사용하였다. 광개시제로는 HP-8, TPO 및 DETX 3종을 조합하여 사용하였고 올리고머로는 bisphenol A epoxy diacrylate를 사용하였다. 본 연구에서는 산성 고분자와 아크릴계 모노머의 함량을 일정하게 유지하면서 광개시제, 올리고머, 그리고 첨가제인 talc의 함량을 변화시키며 실험을 수행하여 광개시제에 따른 제반 물성의 연계성을 고찰하였다. 시험결과 두 가지 이상의 광개시제를 사용해야 경도를 4H 이상 얻을 수 있었고 특히 TPO를 첨가하면 코팅막의 박리 형태를 시트형태로부터 조각형태로 조절하는 것이 가능하였다. 올리고머 함량이 증가하면 경도와 접착성이 증가하지만 박리시간 역시 증가하였고 talc 함량은 20 wt%에서 가장 우수한 결과를 나타내었다.

동맥관 개존증을 보이는 개에서의 이중 결찰술 실시 3예 (Application of double ligation in 3 dogs with patent ductus arteriosus)

  • 윤헌영;김준영;한현정;장하영;이보라;남궁효선;박희명;정순욱
    • 대한수의학회지
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    • 제46권2호
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    • pp.171-175
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    • 2006
  • Three dogs with suspected patent ductus arteriosus were referred to Veterinary Medical Teaching Hospital of College of Veterinary Medicine, Konkuk University because of cough, shortness of breath, exercise intolerance, and syncope, Continuous murmur and thrill were detected in physical examination. Left ventricular enlargement, cardiomegaly, bulged main pulmonary artey were found in radiography. Tall R wave, wide P wave, atrial fibrillation, and turbulent flow were observed in electrocardiogram and echocardiogram. Thoracotomy was performed at left fourth intercostal space under isoflurane anesthesia. Patent ductus arteriosus was double ligated with 1-0 silk. The median (mean ${\pm}$ SD) diameter of patents was $8.0{\pm}2.0mm$. The median operation time was $36{\pm}6.6min$. On examination right after surgery, continuous murmur, thrill, atrial fibrillation, and turbulent flow were disappeared. On 30 days after surgery, clinical signs, left ventricular enlargement, and, bulged main pulmonary artery were disappeared. VHS 12.5 and 13.5, R wave 3.3 and 3.0 mV, and P wave 0.05 and 0.05 sec were decreased to 10.0 and 10.5, 1.8 and 2.0 mV, and 0.04 and 0.04 sec respectively in case 1 and 2. Ratio of aorta and main pulmonary artery in diameter was changed 1 : 1.3 and 1 : 1.6 into 1 : 1.1 and 1 : 1 respectively in case 1 and 2. Mild tear developed during dissection in case 3 and hemorrhage was controlled by vascular Devakey forceps. However, the dog died. On 12 months after surgery, patients (case 1 and case 2) have not showed abnormal signs.