• Title/Summary/Keyword: 광범위절제

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Reconstructive Considerations in Webster's Modification of Bernard Operation after Wide Excision of Squamous Cell Carcinoma on Lower Lip (하구순 편평세포암의 광범위 절제 후 Bernard씨 술식의 Webster씨 변법을 이용한 재건)

  • Nam, Su Bong;Bae, Yong Chan;Choi, Chi Won
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.168-174
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    • 2005
  • Reconstruction of the lower lip requires consideration of several factors. There should be retained sensation, maintenance of oral sphincter function, and a large enough opening for the mouth. In addition, it is important to achieve an aesthetically acceptable appearance. Webster's modification of Bernard operation is one of good methods which satisfy above mentioned goals. The purpose of this article is to present the results and review the perioperative problems after reconstruction of the lower lip by this operation. We reviewed seven patients after surgical reconstruction by the same method between January of 1996 and December of 2003. Five patients were male and two were female. The mean follow-up period was 15 months. We obtained functionally and cosmetically acceptable appearance after reconstruction. Most of the reconstructed lower lips were large enough for full mouth opening, but one patient required additional commissuroplasty, and one other patient was treated with wound revision for dehiscence resulting from protrusion of mandibular lateral incisor tooth. All other patients accepted their facial appearance. In conclusion, careful planning and consideration for dental problems and proper closure tension may ensure satisfactory outcome & lower lip competence, when using this modified operative method for lower lip reconstruction.

Right Ventricular Myxoma Obstructing Right Ventricular Outflow Tract (점액종에 의한 우심실 유출로 협착)

  • Song Kwang-Jae;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.637-639
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    • 2006
  • Cardiac myxoma is the most common primary tumor of the heart, but right ventricular myxoma causing outflow obstruction is relatively rare. A 15 years old girl developed dyspnea on exertion and intermittent syncope caused by a right ventricular mass obstructing the right ventricle outflow tract. Transthoracic echocardiography revealed $3.6{\times}3.0\;cm$ sized pedunculated subpumonic mass originating from the right ventricular anterior free wall. The patient underwent an emergency operation, consisting of the removal of the mass by wide excision of the tumor base and PTFE (polytetrafluoroethylene) patching of the right ventricular anterior free wall defect. Pathological findings of the mass were compatible with myxoma, and the patient was discharged uneventfully 7 days after the operation.

Synovial Sarcoma with Femoral Vein Invasion (대퇴정맥을 침 범한 활액막육종 1예보고)

  • Seo, Jae-Jeong;Park, Seung-Il;Kim, Eun-Gi
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.454-457
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    • 1996
  • The Incidence of synovial sarcoma Is very low but sarcoma Is a well-defined entity, which occurs primarily around large Joints and usually in association with tendon sheaths, bursae or the capsule. Recently we experienced a case of synovial sarcoma which invaded the right femoral vein of 433 5-year-old man. The tumor was widely excised incl ding the invaded femoral vein, and vein reconstruction was done using saphenous vein graft. The postoperative course was uneventful without intractable edema nor disability.

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A Case of Localized Subaortic Stenosis Associated with Aortic Regurgitation (대동맥판폐쇄부전을 동반한 국소성)

  • 김삼현;서필원
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.780-784
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    • 1996
  • The localized form of subaortic stenosis shows a spectrum of pathological lesions varing from dis- crete membrane to a thickened flbromuscular collar. Aortic valve is commonly involved late in the pro- cess resulting in regurgitation. Because of the likelihood o the progressive obstruction and aortic regurgitation, early elective oper- ation should be considered for the patient with subaortic stenosis. We experienced a case of localized fibromuscular subaortic stenosis associated with aortic regurgi- tation. Excision of the fibromuscular ridge and septal myectomy-myotomy relieved the subaortic seen- osis. Regurgitant aortic valve was repaired by peeling away the Hbrotic tissue on the cusps and subcommissural annuloplasty at the each commissural area. On postoperative echocardiographic examination, the systolic pressure gradient between left ventricle and aorta decreased markedly and the aortic regurgitation was not detected at all.

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(The Influences of Internet Chafing Language to the Writing of Elementary Students) (사이버공간에서의 언어 사용이 초등학생들의 글쓰기에 미치는 영향)

  • 김종진;김여진;김종훈
    • Journal of the Korea Computer Industry Society
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    • v.3 no.9
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    • pp.1129-1144
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    • 2002
  • The purpose of this study was to see the influences of net-speak on actual writing of elementary schoolchild. So I investigated diaries and letters of elementary schoolchild in Jeju. And I researched through questionaire their recognition of net-speak. As the result, it became clear to be widely used net-speak both diaries and letters, especially letters. In computer education, first, Information and communication ethics must be educated. The second, software which filtering net-speak have to be developmented. In language education, first, it must be researched to influence the replacing a ellipsis symbol with a period or omitting the subject, complement, and object in sentence on elementary schoolchild's way of thinking. The second, it needs to be researched the influences of the misuse of sign in sentences on the writing of elementary schoolchild.

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A Metastatic Giant Cell Tumor of the Soft Tissue of the Thoracic Wall - A case report - (흉벽 연부조직에 발생한 전이성 거대세포종 - 1예 보고 -)

  • Shin, Duk-Seop;Lee, Jang-Hoon;Choi, Jun-Hyuk;Chung, Tae-Eun
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.526-528
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    • 2007
  • A giant cell tumor of bone is a benign bone tumor, but has very high local recurrence rate and, very rarely metastasizes to the lung or a distant area. We report a case of a 29-year-old male patient presenting with a metastatic giant cell tumor of the soft tissue of the chest wall, who underwent a total resection of the radius for recurrence of the giant cell tumor. The tumor was not related to any bony structure of the thorax. We resected the tumor with a wide surgical margin. No evidence of malignancy was seen in the frozen and permanent pathological report.

Osteosarcoma Arising from Giant Cell Tumor - 2 Cases Report - (거대 세포종에서 발생한 골육종 - 2례 보고 -)

  • Han, Chung-Soo;Lee, Young-Ho;Ha, Jeong-Han
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.144-150
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    • 2001
  • It is not uncommon for sarcomatous transformation of giant cell tumor of bone to occur after radiation, but osteosarcoma arising from giant cell tumor after surgical treatment is very rare and remains an aggressive form of sarcoma of bone with high mortality rate. We experienced 2 cases in whom a osteosarcoma developed long after benign giant cell tumor of bone was removed surgically from the same site. Malignant transformation was presented at 2 years 1 month and 9 years 8 months each after initial surgery. We describe our experience concerning clinical features, methods of treatment and outcomes of osteosarcoma arising from giant cell tumor.

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MULTIPLE MYELOMA OF MANDIBLE : REPORT OF A CASE (하악골에 발생한 다발성골수종의 증례보고)

  • Jang, Hyun-Seok;Lee, Gi-Cheol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.706-711
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    • 1996
  • 다발성 골수증은 다양한 증세를 보이는 형질세포로부터 기원하는 악성종양으로 40세이상의 남성에서 호발되며 alkylating agent 단독, 혹은 corticosteroid와 병용하는 항암제 치료로 생존율이 크게 증가되기는 하였지만 치료후 평균생존기간의 20개월 내외로 완치율이 그다지 높지않은 형편이다. 악골에서의 발생은 극히 드물고 대개 늑골, 편평골, 척추, 골반, 두개골등에 광범위한 patchy destruction의 형태로 나타나는데 악골에 발생할 경우 임상증상은 장기적인 무통성 종창이 가장 흔하며 때로는 동통, 악골의 팽창, 감각이상, 치아의 동요, 악골골절등을 보이기도 한다. 전신적증상으로 무력감, 체중감소, 빈혈, 신부전, hypercalcemia, hyperiviscosity syndrome을 나타내기도 하는데 약 10%의 환자에서 전신적인 amyloidosis를 보인다. 진단은 골수생검상 골수의 plasmacytosis가 10% 이상이면서 혈장이나 뇨전기영동법에서 monoclonal globulin peak이 있을 때 가능하다. 여러 학자들은 처음에는 독립적인 고립성병소로 나타났다가 장기적으로 다발성골수종으로 이행됨을 주장하면서 장기적인 추적을 권하고 있지만 골내 고립성 형질세포종(solitary plasmacytoma in bone), 수질외 형질세포종(extramedullary plasmacytoma) 등은 다발성골수종과는 다른 질환이라 주장하는 등 아직 많은 논란이 있는 형편이다. 치료는 $4000{\sim}6000$ rad의 방사선치료와 여러 가지 약제의 복합적인 항암요법이 사용되고 있으며 국소적인 병소의 경우 외과적 절제술이 추천되기도 한다. 저자들은 59세 여자환자에서 하악골에 발생된 다발성골수종을 치험하였기에 문헌고찰과 함께 보고하는 바이다.

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MR Imaging of Aggressive Angiomyxoma of the Female Pelvis: Case Report (여성 골반에 생긴 공격성 혈관점액종의 자기공명영상: 증례 보고)

  • Kim, Hye-Mi;Pyo, Ji-Eun;Cho, Nam-Hoon;Kim, Nam-Kyu;Kim, Myeong-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.206-210
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    • 2008
  • Aggressive angiomyxoma is a rare tumor that predominantly occurs in the female genital tract. Because of its high tendency for local recurrence, preoperative diagnosis is important to ensure wide excision and reduce recurrence risk. But it is often misdiagnosed due to its rarity. We present two cases of aggressive angiomyxoma: a recurrent case that was initially misdiagnosed and a preoperatively diagnosed case.

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Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius (원위 요골 악성 종양의 광범위 절제술 후 혈행성 유리 비골 두 이식을 이용한 수근관절 재건술)

  • Song, Seok-Whan;Lee, Yoon-Min
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.82-88
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    • 2011
  • Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

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