• Title/Summary/Keyword: 기저절

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Submental Intubation for Maxillofacial Surgery -A Case Report - (구강악안면수술을 위한 악하 기관 삽관 -증례보고-)

  • Kim, Soung-Min;Kwon, Kwang-Jun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.4 no.2 s.7
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    • pp.96-99
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    • 2004
  • 구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

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Sarcoid-Like Reaction after Complete Remission of Malignancy: CT and 18F-FDG PET/CT Features for the Differential Diagnosis from Lymph Node Metastasis (악성종양의 완전관해 후 발생한 사르코이드증 유사 반응: 림프절 전이와의 감별진단에 유용한 CT와 18F-FDG PET/CT 소견)

  • Hyun Ji Kang;Yookyung Kim;June Young Bae;Jung Hyun Chang;Soo-Hyun Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.903-913
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    • 2021
  • Purpose To identify the imaging features indicative of sarcoid-like reactions in patients with intrathoracic lymphadenopathy after complete remission of malignancies. Materials and Methods This study enrolled five patients with histopathologically confirmed sarcoid-like reactions that developed after cancer remission. The clinical features and findings of CT and 18F-fluorodeoxyglucose (FDG) PET/CT were assessed. Results The underlying malignancies included breast, nasopharyngeal, colon, and endometrial cancer and lymphoma. The time intervals between complete remission of malignancy and the diagnosis of sarcoid-like reaction ranged from 6 to 78 months. CT findings of sarcoid-like reaction included bilateral hilar and mediastinal lymphadenopathies (n = 5), pulmonary nodules (1-15 mm) with peribronchovascular, fissural, or subpleural distribution, and interlobular interstitial thickening in the lungs (n = 4). 18F-FDG PET/CT revealed hypermetabolic uptake in the mediastinal and hilar lymph nodes and both lungs in the absence of extrathoracic uptake (n = 3). The sarcoid-like reactions resolved in all patients after corticosteroid treatment. Conclusion In patients with complete remission of malignancies, newly developed bilateral hilar and mediastinal lymphadenopathies with or without pulmonary nodules of perilymphatic distribution, in the absence of recurrence at the primary tumor site and extrathoracic metastasis, may suggest a sarcoid-like reaction. Such cases warrant histologic evaluation of the lymph nodes to prevent unnecessary systemic chemotherapy.

Clinical Experiences of Cardiac Surgery Using Minimal Incision (소절개선을 이용한 심장수술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.373-378
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    • 1999
  • Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

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CASE REPORT OF PILOMAIRICOMA (Pilomatricoma 환아에 대한 증례 보고)

  • Seo, Hyun-Woo;Kim, Ji-Hyuck;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.79-84
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    • 2004
  • Pilomatricoma is a benign soft tissue tumor of hair follicle origin. They occur most commonly in the head and neck region and are usually found in girls during the first two decades of life. Although malignant transformation has been described, it is exceedingly rare. The clinical presentation is typically that of an asymptomatic, superfical, solitary, firm mass that is often accompanied by a reddish-blue discoloration of the overlying skin. Histopathologically pilomatricoma are seen as epithelial islands embedded in a cellular stroma. The epithelial component consist of two main cell types : basaloid cells and ghost cells. Intracellular and stromal calcification is reported in many cases. Diagnosis is usually suspected based on palpation of a superficial, rock-hard mass and confirmed by histopathologic examination. Surgical excision is both curative and the treatment of choice. Recurrence is rare. In this case, the radiographs showed a dense calcification, measuring about 1cm diameter. So simple excision was peformed intraorally, and resultantly the lesion was proved to be a pilomatricoma by histological examination.

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Plate Fixation for Fractures of the Coronoid Process of the Ulna (금속판을 이용한 구상돌기 골절의 치료)

  • Shin, Dong-Ju;Byun, Young-Soo;Cho, Young-Ho;Park, Ho-Won;Youn, Hee-Min;Han, Jae-Hui
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.177-184
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    • 2008
  • Purpose: The purpose of this study was to evaluate the results of eight cases of coronoid process fractures that were fixed with a plate. Materials and Methods: Eight coronoid process fractures were treated by plating and these cases were reviewed retrospectively. Six patients were men and two were women. The average age was 41 years (range: 22-79) at the time of injury. According to Regan's classification, there were five type 2 and three type 3. According to O'Driscoll's classification, there were five anteromedial type and three base type. Open reduction and internal fixation with a plate were performed through a medial approach by splitting of the two heads of the flexor carpi ulnaris. The patients were follow-up for a mean of 15.8 months (range: 6-25). We evaluated the clinical outcomes with using the Mayo Elbow Performance Score. Results: The average active motion of the elbow joint was $120^{\circ}$. The average Mayo Elbow Performance Score was 86.9. There were 5 excellent results, 1 good result and 2 fair results. Summary: Plating through a medial approach of the elbow provided stable fixation and satisfactory union for treating displaced coronoid process fractures with the unstable elbow.

PERIODONTAL RESPONSE FOLLOWING APPLICATION OF INTRUSIVE FORCES TO THE INCISORS WITH BONE LOSS AND PERIODONTAL DISEASE IN ADULT DOGS (골결손과 치주질환 유도 후 성견 절치의 실험적 함입이동시 치주조직의 반응)

  • Hwang, Hyeon-Shik;Park, Yang-Soo;Choi, Hong-Ran
    • The korean journal of orthodontics
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    • v.28 no.3 s.68
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    • pp.431-440
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    • 1998
  • While periodontal disease results in the extrusion of upper incisors with interdental spacing in adult patient, the intrusive movement should be executed for the rehabilitation in terms of esthetics and function. The present study was peformed to investigate the periodontal response following orthodontic intrusion of teeth with infrabony pocket. Bone defect and periodontal disease were produced adjacent to the both maxillary second lateral incisors in four adult dogs. Four weeks later, a flap operation was performed to eliminate inflammation and a reference notch was made on the root surface at the level of bottom of each defect. Two weeks after periodontal surgery, 4 weeks of intrusion and subsequent another 4 weeks of retention was executed on the right side of incisors while left incisors served as the control. Through the histologic analysis, following results were obtained. 1. Histologic section of control side showed the reduction of pocket depth after flap operation. However, the status of long junctional epithelium was observed while new connective tissue attachment occurred in a small area adjacent newly formed cementum 2. Epithelial attachment was less around the intruded incisor while new connective tissue attachment was much more compared to the control side. 3. Plenty of cells were observed in the connective tissue around the reference notch of the intruded incisor and the degree of the new cementum formation was higher in the intruded incisor than the control. The results of the present study suggested that an orthodontic intrusion of periodontally involved and extruded incisors could be carried out with a desirable periodontal response, provided that inflammation is under control.

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The Effect of Quality of Life and Perceived Fairness on Support for Real Estate Deregulation: the Moderating Role of the Prospect of Upward Social Mobility (삶의 질과 공정성에 대한 인식이 부동산 규제 완화 지지에 미치는 영향: 계층상승에 대한 전망의 조절효과를 중심으로)

  • Roh, Minjung
    • The Journal of the Korea Contents Association
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    • v.22 no.5
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    • pp.203-213
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    • 2022
  • This study aims to examine the impact of decline in quality of life on perceived fairness and support for real estate deregulation. The rise of dissatisfaction due to the deterioration in the quality of life can increase the blame for the unfairness of the external social system, which may boost support for government-led market regulation to correct such unfairness. This impact of perceived fairness on quality of life furthermore could be more pronounced when the prospect of upward social mobility is pessimistic. That is, when people expect that they are more likely to be the socially underprivileged who are to be more vulnerable to the fallout from the unfair operation of social system, the possibility of associating the deterioration in quality of life and the decrease in perceived fairness could be more pronounced. To test these predictions, this study used the dataset comprising a total of 6,300 survey responses and substantiated such predictions. Overall, these results not only offer an opportunity to take a more detailed look at the underlying causes of the recent rise of the issue of fairness, but also contribute to broadening the understanding of how individual support for government's deregulation of real estate varies as a function of perceived fairness and prospect of upward social mobility.

Stiffness Analysis of Spring Mechanism for Semi-Automatic Gripper Motion of Tendon-Driven Remote Manipulator (와이어 구동방식 원격조작기용 그리퍼의 반자동 파지 및 해제 동작을 위한 스프링 강성 분석)

  • Yu, Seung-Nam;Lee, Jong-Kwang
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.36 no.11
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    • pp.1405-1411
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    • 2012
  • Remote handling manipulators are widely used for performing hazardous tasks, and it is essential to ensure the reliable performance of such systems. Toward this end, tendon-driven mechanisms are adopted in such systems to reduce the weight of the distal parts of the manipulator while maintaining the handling performance. In this study, several approaches for the design of a gripper system for a tendon-driven remote handling system are introduced. Basically, this gripper has an underactuated spring mechanism that is combined with a slave manipulator triggered by a master operator. Based on the requirements under the specified tendon-driven mechanism, the connecting position of the spring system on the gripper mechanism and kinematic influence coefficient (KIC) analysis are performed. As a result, a suitable combination of components for the proper design of the target system is presented and verified.

Clinical Presentation of Paraganglioma in Orthopaedics - Report of Two Cases - (정형외과 영역에서의 부신경절종의 임상 양상 - 2례 보고 -)

  • Lee, Sang-Lim;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo;Kim, Hyung-Ho;Kim, June-Hyuk
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.94-99
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    • 2005
  • Paraganglioma is a neoplasm consisting of sympathetic neuroendocrine cells, which arise from neural ectoderm of extra-adrenal paraganglia. It often occurs in thyroid, carotid body, mediastinum, lung, duodenum, the retroperitoneal area and periaortic area. Malignant paraganglioma is defined not by the histological diagnosis, but by spread to regional lymph nodes or distant metastasis. Rare bone metastasis mostly occurs in the base of skull or spine, and even it rarely metastasizes to pelvis or femur. We would like to report two cases of paraganglioma; one in the subcutaneous fat layer that was mistaken for a vascular tumor, and the other in the retroperitoneal space with early bone metastasis.

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Generation of Subdivision Surface and First-order Shear Deformable Shell Element Based on Loop Subdivision Surface (서브디비전의 다중해상도 기능을 이용한 곡면의 모델링과 유한요소 해석)

  • 김형길;서홍석;조맹효
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.17 no.2
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    • pp.151-160
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    • 2004
  • In the present study, Loop scheme is applied to generate smooth surfaces. To be consistent with the limit points of target surface, the initial sampling points are properly rearranged. The pointwise errors of curvature and position in the sequence of subdivision process are evaluated in the Loop subdivision scheme. A first-order shear deformable Loop subdivision triangular element which can handle transverse shear deformation of moderately thick shell are developed. The developed element is more general than the previous one based on classical shell theory, since the new one includes the effect of transverse shear deformation and has standard six degrees of freedom per node. The quartic box spline function is used as interpolation basis function. Numerical examples for the benchmark static shell problems are analyzed to assess the performance of the developed subdivision shell element and locking trouble.