• 제목/요약/키워드: surgical diseases

검색결과 918건 처리시간 0.031초

Odontogenic carcinosarcoma of the mandible: a case report and review

  • Kim, Il-Kyu;Pae, Sang-Pill;Cho, Hyun-Young;Cho, Hyun-Woo;Seo, Ji-Hoon;Lee, Dong-Hwan;Park, In-Shu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권3호
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    • pp.139-144
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    • 2015
  • Odontogenic carcinosarcoma is an extremely rare malignant odontogenic tumor with only a few reported cases. It is characterized by a true mixed tumor showing malignant cytology of both epithelial and mesenchymal components. It has been assumed to arise from pre-existing lesions such as ameloblastoma, ameloblastic fibroma, and ameloblastic fibrosarcoma. To date, the reported cases have exhibited considerably aggressive clinical behavior. The case of an odontogenic carcinosarcoma in the mandible of a 61-year-old male is described herein. The tumor destroyed the cortex of the mandible and invaded the adjacent tissues. Treatment was performed by surgical resection and reconstruction. The purposes of this article are to introduce odontogenic carcinosarcoma through this case study, to distinguish it from related diseases and to discuss features of the tumor in the existing literature.

소아 서혜탈장의 진단시 Silk-glove test의 유용성에 대한 연구 (Effectiveness of Silk-glove Test in the Contralateral Exploration of Inguinal Hernia in Children)

  • 구본용;김재천;정연준
    • Advances in pediatric surgery
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    • 제12권1호
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    • pp.11-16
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    • 2006
  • Inguinal hernia is one of the most common surgical diseases in pediatric patients. But the management of the side opposite the clinically apparent inguinal hernia, the "silent side" is controversial. Four hundred fifty-eight cases of pediatric inguinal hernias, operated by one pediatric surgeon at the Divisionof Pediatric Surgery, Department of Surgery, Chonbuk National University Hospital from January 1998 to December 2002, were reviewed retrospectively to determine the characteristics and significances of the silk-glove test on the side opposite the clinically apparent inguinal hernia. Males were preponderant as 2.8:1. Allhernias were of the indirect type and were repaired by high ligation of the sac. There were 238 (52.0 %) right sided hernias, 160 (35.0 %) were on the left and 60 (13.0%) were bilateral. The number of patients with a positive silk-glove sign on the contralateral side was 158(39.7 %), and 133 of these had a contralateral patent processus vaginalis. Positive predictive value of Silk-glove test was 84.2 % (133/158). The silk-glove test is a simple, safe, and relatively accurate method for contralateral exploration in the unilateral inguinal hernias in children.

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Recent advances in pediatric interventional cardiology

  • Kim, Seong-Ho
    • Clinical and Experimental Pediatrics
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    • 제60권8호
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    • pp.237-244
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    • 2017
  • During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

도농 지역에서 만성 요통 환자의 우울증 평가 (Assessment of Depression in Chronic Back Pain Patients in Urban-rural areas)

  • 이정모;김종문;김종훈;정진상
    • 한국지역사회생활과학회지
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    • 제15권2호
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    • pp.159-166
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    • 2004
  • This study was undertaken to investigate the severity of depression and to analyze various factors related to depression in chronic back pain patients in urban-rural areas. In this study, 30 patients who suffered from back pain more than 6 months, and 30 normal subjects who had similar demographic characteristics as the patient group were evaluated using the Back Depression Inventory(BDI). Various factors such as age, sex, causes of back pain, vocational history, pain continuity, visual analogue scale(VAS), duration of pain, type of management, and urban or rural residence were recorded for the study group. The results are 1) The study group revealed higher BDI scores than the control group(p<0.05). 2) The patients who were older and had higher VAS, longer duration of pain, or previous history of surgical management for back pain, and an urban 033residence revealed higher BDI scores(p<0.05). 3) The BDI scores were not significantly influenced by the subjects' sex, causes of back pain, pain continuity, and vocational history in the study group(p>0.05). From this study, we concluded that a Psychosocial approach is required for the management of chronic back pain patients. Also, it is necessary to assess the factors, which are making depression worse in other chronic diseases for comprehensive rehabilitation.

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내·외과 병동에 입원한 노인들의 무력감 지각정도에 관한 연구 (Perceived Powerlessness in Hospitalized Elderly Patients)

  • 최수정
    • 성인간호학회지
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    • 제13권4호
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    • pp.601-609
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    • 2001
  • Purpose: The purpose of this study was to identify the degree of perceived powerlessness in hospitalized elderly patients of the medical and surgical unit. Method: The instrument for this study was the Powerlessness Behavioral Assessment Tool(Miller, 1983). The reliability of the instruments was .85. The data was analyzed by descriptive statistics, t-test, and ANOVA. Results: The results were as follows ; 1. The mean score of powerlessness was $35.02(SD={\pm}9.24)$ in a range of 19 to 64, and the mean of powerlessness was total 1.84. Among 4 subscales, the highest score was in the area of verbal response (M=1.98), and the lowest score for powerlessness was in the area of daily activities(M=1.74). In all items, 'verbal expression of fatalism' showed the highest score(M=2.78), and 'verbal expressions of giving up' showed the lowest score(M=1.38). 2. There were significant differences in the level of powerlessness according to hospitalization experience(t=-3.03, p=0.006), medical treatment experience(t=.291, p=.004). Especially, there was significant difference according to the hospitalization experience of the hospital in all sub- scales. Conclusion: Based on these conclusions, nursing education for patient's diseases and treatment can be used for proper nursing intervention in reducing the level of powerlessness of hospitalized elderly.

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두개골의 결손과 동반된 재발성 세균성 뇌막염 2례 (Recurrent Bacterial Meningitis Secondary to Cochlear Aplasia, Right and Acquired Cribriform Plate Defect due to Trauma)

  • 장수희;김선준;김정수
    • Pediatric Infection and Vaccine
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    • 제5권2호
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    • pp.283-288
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    • 1998
  • Recurrent meningitis in children is not only a potentially life threatening condition, but often involves the child in the trauma though repeated hospital admissions and multiple invasive investigations to find the underlying causes. Symptoms and signs of CSF rhinorrhea or otorrhea are infrequent in these patients and difficult to diagnose in young children. All young children treated for meningitis should then be administered an evoked potential audiometry as a post-treatment test. If sensorineural hearing loss is identified, the clinician should be alerted to the possibility of CSF leakage as the cause of the meningitis. Radiologic studies should be performed to rule out preexisting congenital, or acquired, abnormalities requiring surgical exploration. Two young children with recurrent meningitis due to a right cochlear aplasia and a cribriform plate defect caused by trauma are presented to illustrate the problems of diagnosis and management. A review of literatures will also be presented briefly.

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후종격동 종괴로 발견된 골수외 조혈 종괴의 비디오 흉강경 수술을 이용한 절제 1예 (VATS Resection for a Posterior Mediastinal Extramedullary Hematopoietic Mass: Resection of Extramedullary Hematopoiesis)

  • 장지원;맹영희
    • Journal of Chest Surgery
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    • 제43권5호
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    • pp.542-545
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    • 2010
  • 골수외 조혈은 만성 빈혈을 유발하는 혈액 질환이 있는 환자에게 종종 나타날 수 있는 보상 기전으로 알려져 있으나 무증상 환자에게 종격동 종괴로 발견되어 수술적 절제를 하게 되는 경우는 드물게 보고되고 있다. 흉강 내에 발생하는 경우 후 종격동에 흔히 발생하는 신경성 종양과의 감별이 필요하고, 출혈의 위험이나 접근상의 어려움 때문에 미세 침 흡인 생검이 권장되지 않으므로 진단과 치료를 위해 과거에는 주로 개흉을 통한 절제를 실시하였으나 최근에는 비디오 흉강경을 이용한 수술이 시행되고 있다. 이 증례에서는 59세 남자 환자가 우연히 발견된 후종격동의 골수외 조혈 종괴에 대해 비디오 흉강경을 이용한 절제 후 합병증 없이 퇴원하였고 외래 추적 관찰 중이며 현재까지 혈액학적 질환의 증거나 재발의 증거는 없기에 이를 보고하는 바이다.

의료명상(MDCT)을 이용한 간 동맥의 영역 분할에 관한 영상처리 (A Study on an Image Processing for Segmentation of Liver Arteriography Using Medical Image(MDCT))

  • 최승권;조용환;이병록
    • 한국콘텐츠학회논문지
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    • 제5권5호
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    • pp.305-305
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    • 2005
  • 현대사회에 있어서 질병은 매우 다양하게 발견되고 있다. 또한 한번 발병하면 아니면 적절한 검진시기를 놓쳐 돌이킬 수 없는 상황을 접하게 되는 경우가 종종 있다. 사회가 발전하면서 과도한 비즈니스와 음주 흡연 등으로 우리의 간은 매우 피곤한 상태에 놓이게 되며 질병 발생율도 매우 높다. 여러 질병 중 특히 간에 관련된 질병은 회복이 불가하여 장기이식수술에 의존하는 편이다. 이와 관련하여 본 연구는 MDCT로 얻어진 영상을 3차원 영상 기법으로 간의 형상을 렌더링 하여 체적을 구하고 간 이식 수술시 혈관과의 분리 작업을 통해 절개 라인을 결정할 수 있도록 미리 시물레이션 할 수 있는 영상처리 기법을 개발하고자 간 영역 자동 추출 알고리즘을 적용하여 시물레이션 한 결과 수술을 용이하게 집도할 수 있도록 새로운 장을 열게 되었다.

항응고제 사용 환자에서 지속적 경막외 제통술후 발생한 경막외 혈종 1예 -증례 보고- (Epidural Hematoma Following Continuous Epidural Analgesia in Patient Receiving Anticoagulant Therapy -A case report-)

  • 유경연;임웅모;박준서
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.271-274
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    • 1996
  • Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at $T_{8-9}$ interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at $T_{8-9}$ interspace. Four days later, he died due to underlying diseases. Central neural blockade in patient with anticoagulant therapy is contraindicated in most cases. If is undertaken, close observation of patients's neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.

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초음파와 자기공명영상으로 발견된 족근관 주위 결절성 낭종 -증례보고- (A Ganglion Cyst around the Tarsal Tunnel Detected by Ultrasonography and MRI -A case report-)

  • 박수영;남상건;안상범;김용철;이상철
    • The Korean Journal of Pain
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    • 제22권1호
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    • pp.65-67
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    • 2009
  • Tarsal tunnel syndrome is often misdiagnosed it shares clinical features with other diseases of the lower extremity such as lumbar radiculopathy and arthritis. Failure to diagnose and treat neuropathies effectively can cause permanent neuropathic pain. We report a case of a ganglion cyst detected early using ultrasonography and MRI in a 51-year-old man who complained of rapidly aggravating pain, numbness and paresthesia on the great toe and the first metatarsal area in the sole, symptoms that resembled tarsal tunnel syndrome. Surgical treatment could be performed early with no permanent sequelae. We could also avoid repeated steroid injections or prescription medications.