• 제목/요약/키워드: proximal

검색결과 2,583건 처리시간 0.035초

Modified Proximal Scarf Osteotomy for Hallux Valgus

  • Young, Ki Won;Lee, Hong Seop;Park, Seong Cheol
    • Clinics in Orthopedic Surgery
    • /
    • 제10권4호
    • /
    • pp.479-483
    • /
    • 2018
  • Background: We developed a modified proximal scarf osteotomy technique for moderate to severe hallux valgus in an attempt to obtain better correction of the deformity. In addition, we compared the clinical and radiographic results of this modified technique with those of the classic scarf osteotomy reported in other studies. Methods: Between December 2004 and July 2009, 44 cases of modified proximal scarf osteotomy was performed in 35 patients with moderate hallux valgus. The American Orthopedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, range of motion of the first metatarsophalangeal joint, and radiographic results were evaluated. Results: The mean hallux valgus angle and the mean first intermetatarsal angle improved from an average of $32.2^{\circ}$ and $14.3^{\circ}$, respectively, to an average of $12.5^{\circ}$ and $8.6^{\circ}$, respectively. The distal metatarsal articular angle improved from an average of $18.7^{\circ}$ to $12.4^{\circ}$. The preoperative mean AOFAS and VAS scores were 47 points and 7 points, respectively, which improved to 86 points and 1 point, respectively, at the final follow-up. Limited range of motion occurred in two cases postoperatively. The height of the first metatarsal-cuneiform joint, which was an average of 15.9 mm preoperatively, did not change. The first metatarsal-talus angle increased from an average of $4.1^{\circ}$ to $7.1^{\circ}$. Conclusions: The modified proximal scarf osteotomy for the treatment of moderate hallux valgus showed similar results with the classic scarf osteotomy with regard to changes in the first intermetatarsal angle and postoperative satisfaction. Therefore, we suggest the modified proximal scarf osteotomy be considered as well as other proximal osteotomy in the treatment of moderate to severe hallux valgus.

Proximally based sural artery flap for the reconstruction of soft tissue defects around the knee and proximal third of the leg in India: a clinical study

  • Palukuri Lakshmi;Sreedharala Srinivas;Dharmapuri Madhulika;Sanujit Pawde;Ajo Sebastian;Swathi Sankar;Sandeep Reddy Chintha
    • Journal of Trauma and Injury
    • /
    • 제36권4호
    • /
    • pp.369-375
    • /
    • 2023
  • Purpose: The reconstruction of defects around the knee and the proximal third of the leg necessitates thin, pliable skin with a stable and sensate soft tissue cover. This study analyzed the use of a proximally based sural artery flap for the coverage of such defects. Methods: This prospective clinical interventional study involved 10 patients who had soft tissue defects over the knee and the proximal third of the leg. These patients underwent reconstruction with a proximally based sural artery flap. The study analyzed various factors including age, sex, etiology, location and presentation of the defect, defect dimensions, flap particulars, postoperative complications, and follow-up. Results: There were 10 cases, all of which involved men aged 20 to 65 years. The most common cause of injury was trauma resulting from road traffic accidents. The majority of defects were found in the proximal third of the leg, particularly on the anterolateral aspect. Defect dimensions varied from 6×3 to 15×13 cm2, and extensive defects as large as 16 cm×14 cm could be covered using this flap. The size of the flaps ranged from 7×4 to 16×14 cm2, and the pedicle length was 10 to 15 cm. In all cases, donor site closure was achieved with split skin grafting. This flap consistently provided a thin, pliable, stable, and durable soft tissue cover over the defect with no functional deficit and minimal donor site morbidity. Complications, including distal flap necrosis and donor site graft loss, were observed in two cases. Conclusions: The proximally based sural fasciocutaneous flap serves as the primary method for reconstructing medium to large soft tissue defects around the knee and the proximal third of the leg. This technique offers thin, reliable, sensate, and stable soft tissue coverage, and can cover larger defects with minimal complications.

Testosterone이 토끼 근위 세뇨관 상피세포의 성장에 미치는 영향 (Effect to Testosterone on the Growth of Primary Rabbit Proximal Tubule Cells in Serum-Free Medium)

  • 추민호;박승준;정주호;정지창
    • 대한약리학회지
    • /
    • 제31권1호
    • /
    • pp.85-93
    • /
    • 1995
  • Testosterone이 serum-free medium에서 배양한 토끼의 신장 근위세뇨관 상피세포의 세포성장과 기능에 미치는 영향을 관찰한 바 다음과 같은 결과를 얻었다. 1. 토끼의 신장 근위세뇨관 상피세포는 testosterone 1 nM의 농도에서 유의한 세포 성장 촉진 효과를 나타내었고, testosterone 10 nM이상의 농도에서는 세포성장이 억제되었다. 2. Testosterone은 serum-free medium에서 성장촉진인자의 하나인 hydrocortisone을 growth supplement로 넣어준 serum-free medium에서 토끼 신장의 근위세뇨관 상피세포의 성장을 촉진시키었다. 3. Testosterone은 hydrocortisone을 growth supplement로 넣어준 serum-free medium에서 토끼 신장의 근위세뇨관 상피세포의 성장을 촉진시키었다. 4. Testosterone은 Northern blot analysis에 의하여 확인한 토끼 신장의 근위 세뇨관 상피세포의 ${\beta}-actin$ mRNA level은 증가되었다. 이상의 결과로 미루어 보아, serum-free 그리고 hormonally defined media에서 testosterone이 토끼의 신장 근위세뇨관 상피세포의 성장 및 기능에 대하여 촉진적으로 작용하는 것은 cellular mecrofilament의 중요한 구성단백의 하나로 밝혀진 ${\beta}-actin$의 합성 증가에 기인하는 것으로 생각된다.

  • PDF

교정용 밴드를 이용한 구치부 2급 와동의 복합레진 수복 (CLASS II COMPOSITE RESIN RESTORATION USING ORTHODONTIC BANDS)

  • 박성동;박기태
    • 대한소아치과학회지
    • /
    • 제32권1호
    • /
    • pp.13-17
    • /
    • 2005
  • 소아, 청소년 환자의 경우 성인에 비해 구치부 인접면 우식의 빈도가 높은 편이며, 그 수복 재료에 있어서 심미성이나 치질 삭제량 감소 등의 이유로 복합레진의 사용이 늘어나고 있는 추세에 있다. 복합레진을 이용한 구치부 인접면 수복에 있어서, 술자의 기호와 기술에 따라 여러 가지 매트릭스 밴드를 선택할 수 있으며, 이러한 매트릭스 밴드는 인접면 변연의 적합성과 이에 의한 미세 누출의 감소, 타액에 대한 방습 효과 및 마무리와 연마과정을 용이하게 하는 등 많은 임상적인 기능을 가진다. 본 증례에서는 복합레진과 교정용 밴드를 이용하여, 유치와 영구치 각각의 인접면 우식의 치료를 시행하였으며, 교정용 밴드를 이용한 2급 와동의 복합레진 충전에 있어서 기존의 매트릭스 밴드를 이용하는 경우에 비해 다음과 같은 장점이 있다고 판단하였다. 1. 우수한 변연 적합성에 의해, 치아 외형의 재현이 용이 하였으며 타액에 대한 방습 효과도 우수하였다. 2 복합레진의 충전이나 중합에 있어서, 교정용 밴드의 견고성에 의해 수복물의 변형이 작다고 판단되었다. 3. 간격 유지 장치 등의 이유로 교정용 밴드의 장착을 많이 시행하고 있는 소아치과 의사의 경우, 타과 전공 치과의사에 비해 비교적 교정용 밴드의 장착을 보다 효과적으로 할 수 있으며, 또한 적절하게 선택된 교정용 밴드는 위와 같은 장점들에 의해 수복 치료를 보다 용이하게 해주는 효과가 있다.

  • PDF

근위부 심부정맥 혈전증에서 유증상 폐색전증과 무증상 폐색전증의 비교 (Comparison of symptomatic and asymptomatic pulmonary embolism in proximal deep vein thrombosis)

  • 김동훈;서영우;김균무;고승현;장재석;장태창
    • Journal of Yeungnam Medical Science
    • /
    • 제34권2호
    • /
    • pp.231-237
    • /
    • 2017
  • Background: Deep vein thrombosis (DVT) and pulmonary embolism (PE) are conditions with significant morbidity and mortality. Proximal DVT has a significant association with PE and possible fatal outcomes. Traditionally, PE is subdivided into symptomatic PE and asymptomatic PE, which have different treatments, preventions and prognoses. The growing utilization of computed tomography pulmonary angiography has led to increased detection of PE in DVT patients. This study examined the clinical characteristics and compared symptomatic PE and asymptomatic PE following proximal DVT. Methods: The medical records of 258 DVT inpatients from July, 2012 to June, 2015 were reviewed retrospectively. After excluding the patients who did not performed PE evaluation and were not diagnosed with PE, 95 patients diagnosed with PE following proximal DVT were enrolled in this study. They were divided into the symptomatic PE group and asymptomatic PE group. Results: The body weight, body mass index, thrombus size, thrombus length and location were similar in the two groups. The symptomatic PE following proximal DVT group showed an older age, higher incidence of emergency department access (85.0% vs. 38.7%, p<0.001) and preceding infection (25.0% vs. 1.3%, p<0.001) as well as a higher incidence of immobilization (45.0% vs 13.3%, p=0.016). In the multivariate logistic regression study, preceding infection and emergency department access showed significant association with symptomatic PE. Conclusion: In proximal DVT inpatients, symptomatic PE was associated with emergency department access and preceding infection. The possibility of a symptomatic PE event should be considered in proximal DVT patients, especially those who were admitted through the emergency department and had preceding infection.