• 제목/요약/키워드: retrieval surgery

검색결과 46건 처리시간 0.024초

심장사상충 감염견에서 Flexible Alligator Forceps을 이용한 외과적 치료 (The Efficacy of Surgical Treatment with Flexible Alligator Forceps in Dogs with Heartworm Infection)

  • 윤헌영;정순욱;김준영;한현정;장하영;이보라;남궁효선
    • 한국임상수의학회지
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    • 제22권4호
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    • pp.309-313
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    • 2005
  • 본 연구는 심장사상충 감염견에 있어서 flexible alligator forceps(FAF)을 이용한 외과적 치료법의 효능을 평가하기 위해 실시되었다. FAF를 이용한 외과적 치료를 위해 평균 연령 $5.3\pm3.0\;(mean{\pm}S.D.)$ 년, 평균 체중 $9.3\pm6.5(mean{\pm}S.D.)kg$인 20마리의 심장사상충 감염견을 실험에 사용하였다 그 중 수컷 10마리, 암컷 10마리였다. 성충 제거를 위한 외과적 치료를 isoflurane호흡 마취 하에 FAF완 투시기를 이용하여 실시하였다 FAF를 이용한 외과적 치료방법의 평가를 위해 제거율과 수술시간을 측정하였고 제거 부위를 확인하였다 제거되지 알고 남아 있을 수 있는 성충 확인을 위해 항원 ELISA kit검사와 부검을 실시하였다. 제거율은 심장사상충이 완전히 제거된 15마리를 포함 전체 심장사상충의 $91.4\%$ 였고 수술에 걸린 평균 시간은 $30.0\pm7.6(mean{\pm}S.E.)$이었다. 또한 심장사상충은 우심실, 주폐동맥, 우폐동맥, 그리고 좌폐동맥에서 제거되었다 결론적으로, FAF를 이용한 외과적 치료법은 높은 제거율, 짧은 수술 시간, 그리고 다양한 제거부위와 같은 장점을 보이는 효과적이 방법이며 심장사상충 감염견에서 적용될 수 있는 좋은 치료법으로 사료된다.

동종조직에서의 방사선 멸균효과에 대한 연구 (THE EFFECT OF STERILIZATION OF GAMMA IRRADIATION ON ALLOGENEIC TISSUE MATERIALS)

  • 이은영;김성진;박우윤;김경원;엄인웅;류주연
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권6호
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    • pp.523-527
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    • 2005
  • Allograft donations are commonly found to be contaminated. The most of tissue banks has promoted the use of ionizing radiation for the sterilization of biological tissues. The potential for transmission of human infectious diseases and contamination of microorganism has created serious concern for the continued clinical use of hard and soft-tissue allografts. Tissue banks have employed 15-25kGy for sterilization of hard and tendon allografts, which, according to the national standards, approaches the level at which the tissue quality is adversely affected for transplantation. The donations of allogeneic tissues to the Korea Tissue Bank over a 2-year period were reviewed, and the incidence and bacteriology of contamination were detailed. Clinical outcomes were determined for donors who had positive cultures at the time of retrieval and during the processing and they were compared with those of post sterilization. After exposure of the frozen block bone to 25kGy and the processed tissues to 15kGy of gamma irradiation, the authors were able to demonstrate complete inactivation of the bacteria. The aim of this study was to obtain the effects of gamma irradiation and the irradiation dose according to the type of tissue, through conventional microbiologic test without on influence of biocompatibility in allografts. The contamination rate after the final irradiation sterilization is 0% in the processed allografts. This may be due to the fact that the gamma radiation and processing steps are effective to control contamination.

Presentation and Outcomes of Gastric Cancer at a University Teaching Hospital in Nepal

  • Sah, Jayant Kumar;Singh, Yogendra P;Ghimire, Bikal
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5385-5388
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    • 2015
  • Background: Gastric cancer is the most common gastrointestinal cancer and a leading cause of cancer mortality in Nepal. Survival of gastric cancer patients depends on the stage at which diagnosis is made. The aim of this study was to analyze the presentation and outcomes of gastric cancer patients treated at a tertiary care hospital in Nepal. Materials and Methods: A retrospective analysis of 140 consecutive histologically proven gastric adenocarcinoma cases managed at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal for the period of January 2009 to December 2013 was carried out. Results: One hundred forty out of the total 186 patients with histologically proven gastric adenocarcinoma, were admitted for surgery. The mean age was $59.6{\pm}12.4yrs$ (range 29 to 78 yrs) and the male: female ratio was 2:1. Sixty three (45%) patients featured Tibeto-Burman descent though this ethnic group accounts for only 18% of the Nepalese population. Two-thirds or more patients presented with abdominal pain, anorexia, weight loss and/or vomiting. In 86 (61.5%) of the patients the tumor was located in the lower $3^{rd}$ of the stomach and in only 15% of the patients the tumor was located at the upper $3^{rd}$. Early gastric cancer was diagnosed postoperatively in only 4%. In 54%, the disease was locally advanced and metastatic lesions were found in 14% of the patients. Subtotal (73) or total (11) curative gastrectomies (D1, D1+ or D2) were performed in 84 (60%) patients with average lymph node retrieval of $16.6{\pm}8.2$. Palliative gastrectomies or procedures were performed in 23% of the patients and no intervention (open & close/biopsy) was employed in 15% of the patients. Perioperative morbidity was seen in 10% and mortality in 4%. Three, four and five year survival rates up to the recent follow-up were 17.9%, 11.9% and 8.3%, respectively. Conclusions: Gastric cancer in Nepal is usually diagnosed at an advanced stage and has a poor prognosis. Thus, early detection is the key to improve the survival of gastric cancer patients.

경피적 척추성형 후 발생한 우심방 내 골 시멘트 색전의 도관경유제거술: 시술 중 두 동강나 우폐동맥으로 이동한 색전 (Transcatheter Removal of Bone Cement Embolism in the Right Atrium after Percutaneous Vertebroplasty: The Embolus Broke in Half and Migrated to the Right Pulmonary Artery Intraoperatively)

  • 이선향;연재우;권진태;김혁중;장석기
    • 대한영상의학회지
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    • 제82권4호
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    • pp.1011-1017
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    • 2021
  • 골 시멘트 색전은 경피적 척추성형 후 드물지 않게 발생하는 합병증이다. 이는 보통 작은 폐동맥 색전이고 대부분 무증상이기 때문에 치료를 필요로 하지 않는다. 하지만 심장 내에 생긴 골시멘트 색전은 매우 드물며, 치명적인 결과를 야기할 수 있다. 이전 보고된 증례들은 심장 내 골시멘트 색전을 주로 개심수술을 통해 제거하였으며, 중재시술로 제거한 것은 3개 증례만 보고되어 있었다. 따라서 저자들은 경피적 척추성형 후 발생한 우심방 내 6 cm 크기의 골 시멘트 색전을 도관경유로 안전하게 제거한 1예를 보고하고자 한다. 색전이 시술 중에 두 동강나 우폐동맥으로 이동하였으나 두 개의 스네어와 하나의 필터 제거 장치를 이용하여 서로 반대 방향에서 접근시켜 우폐동맥 내의 색전 조각들을 조심스럽게 잡아 끌어낸 후 쉬스와 일렬로 만들어 제거하였으며, 시술 후 합병증은 발생하지 않았다.

Breast Cancer Inpatients Undergoing Mastectomy from a Hospital in Guangzhou, China: A Retrospective Analysis 2004-2013

  • Lu, Jian-Jun;Li, Heng-Ai;Xiong, Ying
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권11호
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    • pp.4577-4581
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    • 2015
  • Background: To explore the hospitalizations of breast cancer patients undergoing mastectomy, and to provide a basis for management, clinical prevention and treatment. Materials and Methods: We conducted an investigation by means of the retrospective survey and the medical records retrieval system, and made out the data of patients suffered from breast cancer in a hospital in Guangzhou from 2004 to 2013, including age, medical payment methods, pathological type, treatment, treatment results, complications, hospitalization days, cost and so on. Results: The average age of the inpatients was 50.14 years old. The main histologic types were infiltrating duct carcinoma (88.06%). The main surgery was modified radical mastectomy (80.41%). The cure rate was 90.80% during the 10 years. The main medical payment method was self-paying (57.28%). The average hospital stay was 13.51 days, and average hospitalization cost was RMB 23,083.66 yuan, proportion of drug fees up to 39.70%. Postoperative complication rate was 0.79%. The self-paying group was with the highest proportion of drug fees (P<0.05), while the free medical service group was with the longest hospitalization days (P<0.05). Conclusions: The payment methods significantly affected the proportion of drug fees and hospitalization days. The therapeutic effect was satisfactory with less complications and reasonable proportion of drug fees in our hospital.

두경부암 환자의 등록 체제 : 다중등록양식체제와 단일등록양식다중항목체제의 비교 (Head and Neck Cancer Patient Registry System: Comparison between Multiple Sheet System and Single Sheet Multiple Event System)

  • 변성완;김춘동;홍순관;성명훈;김광현
    • 대한두경부종양학회지
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    • 제14권1호
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    • pp.3-14
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    • 1998
  • 재발, 추시 중 소실, 다른 원발성 암의 병발 등으로 복잡해질 수 있는 두경부암 환자 등록에 있어서, '단일등록양식다중항목체제'라는 새로운 체제로, 서울대학교 병원에서 진단한 486명의 두경부암 환자를 대상으로 하여, 데이터베이스를 구성하고, 이의 운용을 '다중등록양식체제'라는 기존의 체제와 비교하였다. 새로운 방법의 구조와 흐름이 보다 간단하고 자료의 검색이 더 효율적이었다. 두경부암 환자 등록의 전용 프로그램 개발에도 이 체제의 도입이 필요할 것으로 사료된다.

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Inadvertent Self-Detachment of Solitaire AB Stent during the Mechanical Thrombectomy for Recanalization of Acute Ischemic Stroke : Lessons Learned from the Removal of Stent via Surgical Embolectomy

  • Kang, Dong-Hun;Park, Jaechan;Hwang, Yang-Ha;Kim, Yong-Sun
    • Journal of Korean Neurosurgical Society
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    • 제53권6호
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    • pp.360-363
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    • 2013
  • We recently experienced self-detachment of the Solitaire stent during mechanical thrombectomy of acute ischemic stroke. Then, we tried to remove the detached stent and to recanalize the occlusion, but failed with endovascular means. The following diffusion weighted image MRI revealed no significant increase in infarction size, therefore, we performed surgical removal of the stent to rescue the patient and to elucidate the reason why the self-detachment occurred. Based upon the operative findings, the stent grabbed the main thrombi but inadvertently detached at a severely tortuous, acutely angled, and circumferentially calcified segment of the internal carotid artery. Postoperative angiography demonstrated complete recanalization of the internal carotid artery. The patient's neurological deficits gradually improved, and the modified Rankin scale score was 2 at three months after surgery. In the retrospective case review, bone window images of the baseline computed tomography (CT) scan corresponded to the operative findings. According to this finding, we hypothesized that bone window images of a baseline CT scan can play a role in terms of anticipating difficult stent retrieval before the procedure.

Successful pregnancy following transmyometrial embryo transfer after robot-assisted radical trachelectomy

  • Hue, Hye Jeong;Choi, Hyun Ji;Park, Jee Yoon;Suh, Dong Hoon;Lee, Jung Ryeol;Jee, Byung Chul;Kim, Seul Ki
    • Clinical and Experimental Reproductive Medicine
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    • 제48권2호
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    • pp.184-187
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    • 2021
  • Radical trachelectomy is a fertility-preserving alternative to radical hysterectomy in carefully selected young women with early-stage cervical cancer. However, in cases with subsequent severe cervical stenosis, assisted reproductive techniques can be difficult. This is a case report of a 34-year-old patient who underwent robot-assisted radical trachelectomy and cerclage for early-stage (IB2) adenosquamous carcinoma. Three months after surgery, the patient underwent ovarian stimulation using a gonadotropin-releasing hormone antagonist protocol. As it was impossible to perform transcervical embryo transfer due to the almost complete absence of the cervical opening, transmyometrial embryo transfer under ultrasound guidance was performed. This resulted in a successful singleton pregnancy. This is the first case of successful pregnancy conceived by in vitro fertilization with transmyometrial embryo transfer in a patient who had previously undergone robot-assisted radical trachelectomy.

2기 대장암 환자에서의 수술 후 보조 항암화학요법 (Post-operative Adjuvant Chemotherapy in Patients with Stage II Colon Cancer)

  • 박재준
    • Journal of Digestive Cancer Research
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    • 제3권2호
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    • pp.89-94
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    • 2015
  • The role of adjuvant chemotherapy in patients with stage II colon cancer remains a controversial issue. Adjuvant chemotherapy aims to eliminate any micrometastatic disease that may have been missed, at the time of surgery. Although one prospective study showed a small but statistically significant benefit with respect to the overall survival for those who received adjuvant chemotherapy, multiple pooled data did not demonstrate any benefit of this therapy in patients with stage II colon cancer. Current national and international guidelines for the adjuvant treatment of stage II colon dose not advise routine implementation of adjuvant chemotherapy, but rather recommend selective use of this therapy for patients with high risk of recurrence. High risk features for recurrence include T4 disease, poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, inadequate retrieval of lymph nodes, bowel obstruction, localized perforation, or positive margins. More recently, prediction tools using gene expression cancer profiles are proposed to identify patients who are most likely to have recurrence and therefore may benefit from postoperative chemotherapy in stage II colon cancer. These novel methods together with conventional prognosticators, will allow us to implement more optimized personalizing adjuvant therapy in these patients.

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Ingestion and surgical retrieval of an endodontic file: a case report

  • Devon Marta Ptak;Elinor Alon;Robert Bruce Amato;Julia Tassinari;Adrian Velasquez
    • Restorative Dentistry and Endodontics
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    • 제48권4호
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    • pp.32.1-32.8
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    • 2023
  • Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide nonsurgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist's office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.