• 제목/요약/키워드: proximal

검색결과 2,583건 처리시간 0.026초

Technical Consideration for Coiling of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm

  • Kim, Jong Hoon;Jeon, Ik Chan;Chang, Chul Hoon;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • 제61권5호
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    • pp.653-659
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    • 2018
  • Objective : Surgical obliteration of ruptured aneurysm of the proximal posterior inferior cerebellar artery (PICA) is challenging because of limited surgical accessibility. In recent years, coil embolization is the first-choice treatment for these lesions. However, coil embolization is not always easy in ruptured PICA aneurysm owing to the variable anatomical diversity of its shapes, its relationship to the parent artery, its low incidence, and accordingly, lesser neurointerventionist experience. Methods : The parent artery and microcatheter for easier navigation and the embolization technique for stable coiling were identified. Results : This study aimed to identify the more appropriate approach route, microcatheter, and strategies for an easier and safer, and more durable coil embolization in the treatment of lesions in the proximal PICA. Conclusion : Coil embolization for aneurysmal subarachnoid hemorrhage due to a ruptured proximal PICA remains a challenge, but with the appropriate coiling plan, it can be treated successfully.

Single-Port Laparoscopic Proximal Gastrectomy with Double Tract Reconstruction for Early Gastric Cancer: Report of a Case

  • Lee, Chang Min;Park, Da Won;Jung, Do Hyun;Jang, You Jin;Kim, Jong-Han;Park, Sungsoo;Park, Seong-Heum
    • Journal of Gastric Cancer
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    • 제16권3호
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    • pp.200-206
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    • 2016
  • In Korea, proximal gastrectomy has recently attracted attention as a better choice of function-preserving surgery for proximal early gastric cancer than total gastrectomy. Of the various strategies to overcome reflux symptoms from remnant stomach, double tract reconstruction not only reduces the incidence of anastomosis-related complications, but is also sufficiently reproducible as a laparoscopic procedure. Catching up with the recent rise of single-port laparoscopic surgeries, we performed a pure single-port laparoscopic proximal gastrectomy with DTR. This procedure was designed by merging the function-preserving concept of proximal gastrectomy with single-port laparoscopic total gastrectomy.

슬관절 부분결손에 대한 혈관부착 비골근위 관절면을 이용한 재건술 (Partial Knee Joint Defect Reconstruction with Vascularized Proximal Fibular Articular Surface)

  • 정덕환
    • Archives of Reconstructive Microsurgery
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    • 제7권2호
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    • pp.157-164
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    • 1998
  • It has been very difficult to managing partial joint defect in any etiologies, especially in children. Unicondylar defect of the tibial condyle in children reconstructed with proximal fibular head with articular cartilage from 1995. Two kinds of transfering methods were used, peroneal artery pedicled ipsilateral fibula head transposition to defective lateral tibial condyle defect that revealed poor prognosis with gradual absorption of transposed fibular epiphysis. Free vascularized fibular head transplantation with microvascular anastomosis underwent in the case with medial condyle defect of tibia which revealed very satisfactory results. Author can conclude with these clinical experiences: 1. Tranposition without epiphyseal vesssels intact is not sufficient in fibular head osteochondral transplantation in reconstruction of tibial condyle defect. That means peroneal arterial vascular pedicle is not enough for transplanted proximal epiphysis maintains its function on articular surface and growth activity in children. 2. The anterior recurrent tibial artery is one of the most important and easy to utilizing vessel in proximal fibular epiphyseal transplantation. 3. Free vascularized fibular head transplantation is hopeful method in reconstruction of the knee joint in the patient with partial joint defect which has no effective solution in conventional methods.

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인공치관 수복 후 인접면 접촉강도의 경시적 변화 (Time Serial Change of Proximal Contact Tightness after Crown Restoration)

  • 나현준;강동완;오상호
    • 구강회복응용과학지
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    • 제26권2호
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    • pp.197-204
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    • 2010
  • 본 실험의 목적은 인공 치관의 수복을 통해 인접치간 접촉강도의 경시적 변화를 관찰하는 것이다. 인공 치관을 통한 단일 치관 수복이 필요한 12명의 성인에서 치아 삭제 전과 인공치관 적합 후의 시간 경과에 따른 접촉강도를 측정하였다. 그 결과 적합 직후의 인접치간 접촉강도는 처음 삭제 전의 접촉강도보다 컸으며 1-2주 이내에 치아삭제 전의 접촉강도와 유사한 양으로 변화하였고 2-4주 후까지 인접치간 접촉강도는 거의 변화가 없고 일정한 접촉강도를 유지하였다.

편측 뇌손상 환자에서 동측 상지의 근위부 및 원위부의 운동 결함에 관한 분석 (Ipsilesional Movement Deficit of Proximal & Distal Upper Extremity in Patients With Unilateral Brain Damage)

  • 권용현;최진호;신화경;배대석
    • 한국전문물리치료학회지
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    • 제12권1호
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    • pp.71-79
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    • 2005
  • The purpose of this study was to analyze the presence of ipsilesional movement deficit, with segmental performance in each proximal or distal upper extremity. The visuoperceptual complex task of the ipsilesional upper extremity was investigated in patients with unilateral brain damage and a control group of healthy sex-age-matched controls. Tracking movements were tested in the proximal and distal upper extremities. Movements were measured by the accuracy index, which was normalized to each subject's own range of motion and took into account any differences between subjects in the excursion of the tracking target. The findings revealed that stroke patients experienced difficulties with tracking movement of both proximal and distal segments in the upper extremities on the so-called "non-affected side", irrespectively of the extent of patient's age, time since onset, or severity of contralateral upper extremity. Therefore, the unilateral brain damage affected ipsilateral motor function of the proximal and distal upper limbs in the performance of complex motor tasks, requiring central processing and the higher order cognitive function in the integrity of both hemispheres.

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구내방사선 사진상의 인접면 치아우식진단능 평가 (Diagnostic Performance of the Intraoral Radiographs on the Interproximal Dental Caries)

  • 김수지;강병철
    • 치과방사선
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    • 제28권1호
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    • pp.37-46
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    • 1998
  • The purpose of this study was to evaluate the diagnostic performance of the senior dental students for the proximal dental caries on intraoral radiographs and to compare it with the dental hospital residents, the reference group. It was also investigated the diagnostic performance according to the carious lesion depth. Thirty-five intraoral periapical and bitewing radiographs with 213 proximal surfaces included in this study were selected from the dental patients at Chonnam National University Hospital. The observers were 181 senior dental students from 5 dental schools and 40 dentists who were second year resident from 5 dental hospitals. They were asked to evaluate the presence or the absence of the proximal dental caries. The results were as follows: 1. The mean of the hitting rate for the overall observers was 184.51 surfaces and the diagnostic accuracy was 86.62%. 2. The diagnostic performance of the sound proximal tooth surfaces was very high, i.e., 91.5% true negative rate and 8.5% false positive rate. 3. The diagnostic performance of the dentist group was higher than the student group(P<0.05). 4. The proximal dental caries perceptibility increased as the lesion depth increased significantly(P<0.001) except no difference between the carious lesion depth III and IV (P>0.001).

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대퇴골 근위부 골흡수가 인공 고관절 대퇴 stem에 미치는 응력에 관한 연구-FEM을 이용한 분석 (A Finite Element Analysis of Stress on the Femoral Stem with Resorption of Proximal Medial Femur after Total Hip Replacement)

  • 김성곤
    • 대한의용생체공학회:의공학회지
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    • 제15권2호
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    • pp.183-188
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    • 1994
  • In clinical orthopaedics, bone resoption in the cortex is often seen post operatively on X-rays or bone densitometry after total hip replacement (THR) in the form of cortical osteoporosis or atropy. Stress shielding of bone occurs, when a load, normally carried by the bone alone, is shared with an implant as a result, the bone stresses are abnormal and with remodelling analysis this may cause extensive proximal bone resoption, possibly weakening the bone bed to the point of failure. The author made finite element models of the cemented and non-cemented type implanted femoral stem with bone resorption of the proximal medial femur and studied the feed back effect of the various degree of bone resoption to THR system by parametric analysis on the stress of the femoral stem and interface. The results of the present finite element analysis implied that the extent of proximal bone resorption has the effect of more increasing stress on the distal stem tip, cement mantle and interface in both type of femoral stem and this high distal stress possibly can cause the mechanical failure of loosening or failure after THR.

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Proximal Interphalangeal Joint (PIPJ) Arthrodesis for Treating PIPJ Osteoarthritis in a Horse

  • Seo, Jeeyoon;Park, Joon-Young;Lee, Minhyun;Cho, Young-Jae;Kim, Byung Hyun;Seo, Jong-Pil
    • 한국임상수의학회지
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    • 제36권5호
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    • pp.292-295
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    • 2019
  • A 2-year-old, 440 kg, thoroughbred gelding showed a lameness grade of 3 out of 5, as well as swelling and heating on the proximal interphalangeal joint (PIPJ). Periarticular new bones due to the arthritis were observed on performing radiography and ultrasonography. PIPJ arthrodesis was performed under general anesthesia. With the PIPJ open, the articular cartilage was removed by using curette, chisel, and mallet. Arthrodesis was performed with a PIP plate and two additional transarticular cortex screws inserted in lag fashion. A cast was placed over the limb distal from the proximal metatarsal bone. At 6 months after surgery, complete union of the PIPJ was confirmed by radiography, and the incision site was well closed. Based on the outcome, a PIP plate with two additional transarticular cortex screws inserted in lag fashion is recommended as a method for treating osteoarthritis of the PIPJ in horses.

무지외반증 환자의 근위 갈매기형 절골술에서 생체 흡수성 나사못을 이용한 고정 (Bioabsorbable Screws Used in Hallux Valgus Treatment Using Proximal Chevron Osteotomy)

  • 신우진;정영우;안기용;서재웅
    • 대한족부족관절학회지
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    • 제22권4호
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    • pp.181-183
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    • 2018
  • Hallux valgus is a deformity that causes pain in the first metatarsophalangeal joint. Surgical methods are quite diverse and a range of osteotomies are used at the proximal and distal part of the metatarsal bone and proximal phalange. Fixation methods, such as plate, screw, K-wire, and others have been used in various ways. The fixation device is often removed with various side effects due to the fixation devices. In the case of instruments that are absorbed in vivo, these procedures are not necessary to remove and there is an advantage of not performing the second operation. Three patients were treated, in which a proximal chevron osteotomy was used with a bioabsorbable screw (K-$MET^{TM}$; U&I Corporation).

Unrecognized bony Bankart lesion accompanying a dislocated four-part proximal humerus fracture before surgery: a case report

  • Lee, Seungjin;Shin, Daehun;Hyun, Yoonsuk
    • Clinics in Shoulder and Elbow
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    • 제25권1호
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    • pp.68-72
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    • 2022
  • Proximal humerus fractures are the third most common fractures, totaling 4% to 5% of all fractures. Here, we present the case of a 39-year-old man with a dislocated four-part fracture of the proximal humerus with a huge bony Bankart lesion. Preoperatively, the bony Bankart lesion of the glenoid was not visualized on computed tomography scans or magnetic resonance imaging because the fracture of the proximal humerus was comminuted, displaced, and complex. It was planned for only the humerus fracture to be treated by open reduction and internal fixation using a locking plate. However, a fractured fragment remained under the scapula after reduction of the dislocated humeral head. This was mistaken for a dislocated bone fragment of the greater tuberosity and repositioning was attempted. After failure, visual confirmation showed that the bone fragment was a piece of the glenoid. After reduction and fixation of this glenoid part with suture anchors, we acquired a well-reduced fluoroscopic image. Given this case of complex proximal humerus fracture, a glenoid fracture such as a bony Bankart lesion should be considered preoperatively and intraoperatively in such cases.