• Title/Summary/Keyword: 광범위절제

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Primary Left Atrial Myxofibrosarcoma -A case report- (좌심방에 발생한 악성 원발성 점액섬유성육종 -1예 보고-)

  • Yoon, Yoo-Sang;Lee, Cheol-Joo;Kang, Joon-Kyu;Kim, Hyung-Tai;Choi, Ho;Lee, Kyi-Beom
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.422-426
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    • 2003
  • Primary cardiac tumor has very low incidence, especially in cases of malignancy. A 29 year old male patient visited our cardiologic clinic for recent aggrevation of dyspnea on exertion and palpitation. Echocardiography showed a large tumor in the left atrium, which suggested the left atrial myxoma. Urgent open heart surgery was taken. The operative finding was fossa ovalis based a large tumor (35$\times$90$\times$50 mm) that invaded the posterior wall of LA and right superior pulmonary vein directly. The tumor was excised well by simple dissection, and the final pathologic report was malignant myxofibrosarcoma. His postoperative course was smooth and he was discharged in good health. Postoperative radiation and chemotherapy had taken with satisfactory clinical outcome.

The Signification of Anterolateral Thigh Free Flap for Reconstruction of Soft Tissue Defect in Malignant Soft Tissue Tumor of Lower Extremity (하지에 발생한 연부 조직 종양의 광범위 절제술 후 재건술에서 전외측 대퇴부 유리 피판술의 유용성)

  • Kwon, Young Ho;Lee, Gun Woo
    • Archives of Reconstructive Microsurgery
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    • v.20 no.2
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    • pp.89-95
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    • 2011
  • Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

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Full mouth rehabilitation in a patient with partial mandibulectomy using CAD/CAM zirconia framework and monolithic zirconia (하악골 부분절제술 시행한 환자에서 CAD/CAM Zirconia Framework와 Monolithic Zirconia를 이용한 전악 수복 증례)

  • Ma, Bo-Young;Park, Hongju;Im, Yeong-Gwan;Park, Chan;Shin, Jin-Ho;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.279-285
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    • 2017
  • Defects due to mandibulectomy often cause hard and soft tissue loss and result in esthetic problems and functional disorders such as mastication, swallowing, and pronunciation. After the mandibular reconstruction, several complications including loss of alveolar bone can cause limitations in maintenance or supporting of removable prosthesis. For these patients, implant-supported fixed restorations have been an appropriate prosthetic restorative method. In this case report, we report the patient who underwent mandibulectomy and mandibular reconstruction owing to oral cancer, and then restored the current dentition functionally and aesthetically by applying zirconia frameworks and monolithic zirconia crowns by computer-aided design and computer-aided manufacturing.

Extraskeletal Ewing's Sarcoma Arising in the Chest Wall (흉벽에 발생한 골외 Ewing's Sarcoma)

  • Kim, Hyung-Woo;Sohn, Hong-Ju;Joo, Mee;Kang, Yun-Kyung;Jeon, Woo-Ki;Lee, Hyuk-Pyo;Kim, Joo-In;Choi, Soo-Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1158-1165
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    • 1997
  • Extraskeletal Ewing's sarcoma is a very rare tumor which was first reported by Angervall and Enzinger in 1975. The common sites of extraskeletal Ewing's sarcoma are bony structures of lower extremities, paravertebral region, and pelvis, but rarely chest wall. Microscopically, extraskeletal Ewing's sarcoma is indistinguishable from the Ewing's sarcoma of bone. We present here a case of extraskeletal Ewing's sarcoma of the left lateral chest wall in a 19-year-old male. Wide extirpation and postoperative combined chemotherapy were done, and we discuss the clinical picture, histopathology, therapeutic management, and prognosis with review of the literature.

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Non Blood Transfusion Limb Salvage Operation in the Distal Femur Osteosarcoma Patient: A Case Report (무수혈로 진행한 대퇴골 원위부 골육종 사지구제술: 증례 보고)

  • Park, Jong Hoon;Park, Si-Young;Lee, Dae Hee;Hwang, Yeok Gu;Lee, Hyun Min
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.36-40
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    • 2014
  • Limb salvage operations for osteosarcoma of the extremity usually consist of wide excision and skeletal reconstruction. Most osteosarcoma patients are anemic prior to the surgery as majority of them undergo preoperative neo-adjuvant chemotherapy; thus, it is necessary to treat anemia before and after the surgery since limb salvage operation tends to accompany significant blood loss. Despite the fact that blood transfusion has bad influence on prognosis, complication, and postoperative outcome of cancer patients, it is still considered as a standard management to fix anemia for limb salvage operations. We would like to present a case report in which the authors succeeded in performing limb salvage operations on patients with distal femur osteosarcoma without transfusion.

Treatment of Giant Cell Tumor of Distal Radius with Wide Resection and Proximal Fibular Graft (광범위한 절제술 후 근위 비골 이식을 이용한 원위 요골 거대세포종의 치료)

  • Kim, Bu-Hwan;Yi, Sang-Hun;Heo, Mu-Jung;Chun, Sang-Jin;Ryu, Chong-Il;Kim, Yong-Jin
    • Archives of Reconstructive Microsurgery
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    • v.11 no.1
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    • pp.67-72
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    • 2002
  • Purpose : Treatment of giant cell tumor of distal radius can be treated in several ways according to the agressiveness of the tumor. We treated 3 cases of widely involved giant cell tumor of distal radius with wide resection and proximal fibular graft and report the results with review of literatures. Material and Method : We have treated 3 cases of giant cell tumor of the distal radius since last 1990. Among 3 cases, two cases were grade III radiologically and treated by wide resection of distal radius and vascularized proximal fibular graft, and one case, grade II radiologically, treated by distal radial resection and non-vascularized proximal fibular graft. We followed up clinical results of above three cases 9 years, 12 years and 2 years. Result : In all three cases, tranplanted fibula graft showed solid union but grade III tumors recurred at 4 year and 6 year postoperatively. One of the case which recurred 4 year later was treated with secondary wide resection and wrist fusion with autogenous iliac bone graft, and didn't show any recurrent finding for these 5 years after re-operation. And another grade III, which recurred at 6th post-operative year, is under follow-up for 6 years after recur without 2nd operation. Grade II case didn't show any recurrent findings on 2 year follow-up. Conclusion : Grade III cases recurred at 4 year and 6 year follow-up. The cause of recurrence was thought to be invasion of remaining tumor cell in the soft tissue. To prevent recurrence, complete resection of primary tumor was necessary.

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Clinical Study of Vascularized Osteocutaneous Fibular Transfer to the Tibia (경골에 시행한 생비골 및 생피부편 이식의 임상적 연구)

  • Lee, Kwang-Suk;Kim, Hak-Yoon;Kang, Ki-Hoon;Shim, Jae-Hak
    • Archives of Reconstructive Microsurgery
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    • v.2 no.1
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    • pp.29-41
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    • 1993
  • Recent advances in microsurgery have made it possible to provide a continued circulation of blood to the grafted bone so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. We reviewed 34 cases of vascularized osteocutaneous fibular transfers to the infected tibial defect complicated with skin defect, which were performed from May, 1982 to January, 1992, and the following results were obtained: 1. Despite of uncontrolled bone infection with skin defect, the vascularized osteocutaneous fibular flap transfer could be performed. 2. In the vascularized osteocutaneous fibula transfer, the patency of anastomoses could be indirectly monitored by observing the color of the skin flap. 3. The vascularized fibula had been hypertrophied with bony union during the follow-up period of 13 months to 6 years and 4 months(average, 30 months) and there was no resorption of the grafted fibula. 4. There was no fracture of the grafted fibula in parti resection of involved tibia. 5. The hypertrophic potentiality of grafted fibula could be inhibited by the infection status as operation site.

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Modified Starnes Operation for Neonatal Stenotic Ebstein Anomaly (신생아 폐쇄성 엡스타인 기형에 대한 변형 Starnes 술식)

  • Lee Seung Hyun;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.633-636
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    • 2005
  • Sixteen-day-old baby with severe Ebstein anomaly underwent emergency operation to relieve progressive hypoxia and congestive heart failure. Operative findings showed huge right atrium and atrialized right ventricle (aRV) with very small functional RV by distal displacemcent of tricuspid valve mechanism. We elected to perform modified Starness operation because biventricular repair was deemed unattainable. After pulmonary and tricuspid valves were primarily closed, aRV was obliterated with multiple sutures from RV apex to the base. Then a PTFE (Gore-Tex, USA) vascular graft was interposed between innominate artery and main pulmonary artery for systemic to pulmonary shunt. The patient was discharged uneventfully, and received bi-directional cavopulmonary shunt 6 months later.

Obturator Bypass Surgery in a Patient with an Infected Femoral Artery Pseudoaneurysm with Sepsis (패혈증을 동반한 감염된 대퇴동맥 가성동맥류 환자에서 폐쇄공우회술을 이용한 치험)

  • Jun, Hee Jae;Han, Il Yong;Yoon, Young Chul;Lee, Yang Haeng;Hwang, Youn Ho;Cho, Kwang Hyun
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.107-110
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    • 2009
  • Infection of the both native and prosthetic vessels in the groin is a very serious disease because of recurrent arterial rupture and sepsis, and both these complications can cause death. The successful treatment of groin infection, including infection of the femoral artery, requires extensive excision of the infected tissues and restoration of the circulation. We experienced a case of obturator bypass in a patient with an infected femoral artery pseudoaneurysm and accompanying sepsis, and this occurred after performing a transfemoral angiogram in an A-V fistula of the carotid artery, and the patient also displayed intracranial hemorrhage.