• Title/Summary/Keyword: 수술적 절제술

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Clinical Application of Mesenchymal Stem Cells in a Dog with Intervertebral Disc Disease (추간판 탈출증이 발생한 개에서 동종의 지방유래 줄기세포의 임상적 적용)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Kim, Jin-Hyun;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.122-127
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    • 2011
  • A 5-year old, intact male, Cocker spaniel dog was referred with paraplegia and loss of deep pain perception. Physical, neurological examinations, radiography, and computed tomography were evaluated. Based on the clinical examinations, the dog was diagnosed with severe disc herniation ($L_2$ to $L_3$ intervertebral disc space). On the next day of presentation (6 days after loss of deep pain perception), hemilaminectomy was performed. After decompression of spinal cord and removal of herniated disc materials, $1{\times}10^6$ canine allogenic adipose tissue-derived mesenchymal stem cells (MSCs) diluted by $50{\mu}l$ saline were directly applied to the injured site of the spinal cord. Ten weeks of follow-up after surgery, full recovery of deep pain perception and motor function were evaluated in both hind limbs. Based on the result, we suggest that the transplantation of allogenic adipose tissue-derived MSCs to dogs with spinal cord injuries could be a considerable method to expect better clinical outcomes in veterinary practice.

Spinal Syringomyelia Secondary to an Intracranial Microcystic Meningioma in a Dog (개에서 척수공동증을 동반한 소낭성 뇌수막종 1례)

  • Won, Sangcheol;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.439-444
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    • 2014
  • A 5-year-old, 2.7 kg female maltese dog was presented a local veterinary clinic with one week history of hindlimb lameness associated with patellar luxation. Reduction of bilateral medial patellar luxation was operated using trochlear resection and lateral reinforcement technique. Three weeks after the surgery, the dog showed bending spine with pain in thoracic and lumbar region, continuous ataxia and intermittent convulsion. Magnetic resonance imaging scanning revealed a hyperintense mass in right frontal lobe of brain and abnormal cavitation from cervical cord to third lumbar cord. Histopathologically, neoplasm in brain composed of meningothelial cells showed loosely reticular or lace-like morphology with numerous extracellular cystic spaces of variable size and shape. Neoplastic cells were positive for vimentin and negative for neuron specific enolase and glial fibrillary acidic protein. Irregular shaped enlarge central canal-like cavity was existed in cervical and lumbar cords. In our best knowledge, this report described the clinical findings, imaging and histopathologic characteristics of unusual intracranial microcystic meningioma with secondary syringomyelia in a dog.

SURGICAL MANAGEMENT OF VELOPHARYNGEAL INCOMPETENCE USING SUPERIORLY BASED PHARYNGEAL FLAP (상부기저형 인두피판을 이용한 구개인두 부전증의 외과적 처치)

  • Ann, Jye-Jynn;Chang, Se-Hong;Park, Chi-Hee;Woo, Sung-Do
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.3
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    • pp.338-345
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    • 1991
  • Velopharyngeal incompetence (VPI) is a condition of inadequate functional valving between the oral and nasal cavities that results in hypernasal speech and nasal air escape. VPI is caused by the following factors ; cleft palate, soft palate defect, pharyngomegaly, velopharyngeal sphincter muscle anomaly and maxillary advancement surgery, etc. Velopharyngeal function is assessed by a variety of measures that include speech evaluation, cephalogram, airflow study, videofluoroscopy and nasoendoscopy. The management of VPI is classified into four main groups ; prosthesis, insertion of implant, palatoplasty and pharyngoplasty. Pharyngeal flap is the most common surgical procedure for correcting VPI since Schoenborn's report in 1875. We report seven cases of VPI which were treated by modified modified superiorly based pharyngeal flap with good results.

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Reconstruction of a Circumferential Penile Shaft Defect Using Bilateral Superficial External Pudendal Artery Perforator Flaps (양측 천외음부동맥 천공지 피판을 이용한 음경둘레 연조직 결손의 재건)

  • Park, Jongohk;Shin, Donghyeok;Choi, Hyungon;Kim, Jeenam;Lee, Myungchul
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.296-300
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    • 2018
  • Penile shaft reconstruction requires adequate soft tissue characteristics as well as constant vascular pedicles when considering a perforator flap. The free flap technique using various donor sites and regional conventional and perforator flaps have been utilized for penile shaft reconstruction. Still, the free flap techniques include challenging surgical procedures in addition to postoperative management. The regional flap can be applied to limited defects due to the size and shape. We performed the bilateral superficial external pudendal artery (SEPA) perforator flaps in order to reconstruct a circumferential penile shaft defect. The circumferential wound has noted necrotic tissue involving superficial (Dartos) fascia. We underwent debridement, preserving deep (Buck's) fascia and corpus spongiosum. Thereafter, the soft tissue defect was covered with bilateral SEPA perforator flaps. The patient has been observed for 27 months, showing penile resilience without deformity or wound-related problems.

Treatment of Potassium Titanyl Phosphate Laser and Radiation Therapv for Tracheal Stenosis (기관 협착에서 레이저와 방사선 치료의 적용)

  • 김광택;김맹호
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1237-1241
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    • 1997
  • Tracheal stenosis is a difficult disease entity to manage. Laser ablation is one effective treatment for treacheal stenosis and can be utilized if tracheal reconstructive surgery is impossible. Potassium titanyl phosphate laser, transmitted via flexible quartz fiber, can be precisely manipulated through flexible bronchoscope under local anesthesia. We treated 7 patients with trach al and broncheal lesion under local anesthesia with KTP laser from January 1995 to July 1996. The patients included three males and four females. The age of patients ranged from 22 to 66 years with a mean of 43.7 years The etiology of tracheal stenosis in patients was stenosis after tracheostomy(3 cases), prolong inturbation in cases of sepsis(1 cases), and the recurrence of lung cancer within endobronchial lesion(2 cases). In the cases of tracheal stenosis treated with laser ablation, there were 2 cases of recurrence of stenosis at the anastomosis site after the operation, 3 cases of stenosis at tracheostomy site, and 2 cases of local recurrence of lung cancer. The site of the tracheal stenosis was the balloon site of the tracheostomy tube(3-4cm inferior to the tracheostomy site, 2-3cm superior to the carina) and the anastomosis site that were narrowed to less than 5mm(4 cases). For the stenosis lesion in the endobronchial area, there were 2 patients with a lesion at the anterior wa l, 1 patient with a lesion at the posterior wall, 2 patients with circumferential stenosis. Laser ablation time was 25.4 $\pm$5.9min and used energy was 1768 $\pm$365J. We have used KTP laser via (lexible bronchoscope without major complications. Adjuvant radiation therapy may prevent fibroblast proliferation which leads to restenosis. In three patients of restenosis after laser ablation, adjuvant irradiation started within 4 hours after laser ablation, and the radiation doses were 1500cGy given in five fraction. In patients with adjuvant radiation therapy, stenosis has not recurred

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Exploratory Arthroscopic Treatment to Diagnose and Treat Osteochondritis Dissecans of the Shoulder Joint in a Dog (개의 어깨 관절에서 박리성 골연골염의 진단과 치료를 위한 탐색적 관절내시경의 적용)

  • Kim, Choong-Sup;Lee, Hae-Beom;Choi, Ul Soo
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.146-149
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    • 2013
  • A 6-month-old, intact male Great Pyrenees (35 kg) was referred with 2 weeks continuous left forelimb lameness to the Chonbuk Animal Medical Center, College of Veterinary medicine, Chonbuk National University. The lameness became worse three days before being referred to the hospital. Upon the physical examination, the patient had pain when the left shoulder joint was palpated, and the lameness was visible in the left forelimb during ambulation on gait examination. There were no remarkable findings on radiological and neurological examination. Osteochondritis dissecans (OCD) was suspected based on medical history and gait tests. As a definitive diagnosis could not be made, exploratory arthroscopic surgery was performed to examine the inside of the shoulder joint. During the operation, mild bicipital tenosynovitis, synovitis and OCD which was located on the caudal medial area of humeral head were revealed. Arthroscopic procedures were used for the treating OCD, including the removal of the OCD flap and debriding of the subchondral defect until hemorrhaging by use of an electrical burr. The patient was discharged a day after surgery. After 2 weeks, the patient again presented at the hospital due to complications, including inflammation of the surgical lesion because of licking and seroma within the subcutaneous tissue. Antibiotics were administered and an aseptic bandage was applied. And simple surgical operations were performed for the removal of the cyst and seroma. Eleven weeks following arthroscopy, the lameness was completely resolved. Arthroscopy has the advantage of allowing gross examination inside the joint capsule. Due to this advantage, arthroscopy is one of the best advanced options for diagnosis in dogs with undiagnosed joint pain.

Selective Dorsal Rhizotomy for Spastic Paraplegia in Cerebral Palsy Using Intraoperative Electromyography Monitoring (뇌성마비 환자에서 수술중 근전도 감시를 이용한 선택적 후근 절제술의 효과에 관한 연구)

  • Kim, Jong-Min;Wang, Kyu-Chang;Bang, Moon-Suk;Chung, Chin Youb;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.1 no.1
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    • pp.19-25
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    • 1999
  • Background & Objectives : In cerebral palsy, spastic paraplegia is one of the most crippling motor manifestations. Reducing the spasticity may improve gait and decrease the incidence of lower-extremity deformities. The spasticity may result from abnormally increased afferent signals via dorsal roots onto interneurons and anterior horn and spreading of reflex activation to other muscle groups. To assess the influence of dorsal rhizotomy to spasticity, the authors analyzed five cerebral palsy patients with spastic paraplegia. Methods : The operation entailed and L1-2 laminectomy, ultrasonographic localization of conus medullaris and identification of lumbosacral dorsal roots. The innervation patterns of each dorsal root were examined by electromyography (EMG) responses to electrical stimulation. Tetanic stimulation was applied to individual rootlets of each root after reflex threshold was determined. the reflex responses were graded and rootlets producing high grade response were selected and cut. Short-term postoperative evaluations were performed. Results : Intraoperative EMG monitoring was satisfactorily performed in all five cases. One month after the operations, all patients showed greatly reduced spasticity which was measured by the instrumental gait analysis. Bilateral knee and ankle jerks were normalized and tip-toe gait with scissoring disappeared in all patients. Conclusion : Intraoperative EMG monitoring seems useful for the selective dorsal rhizotomy to reduce spasticity.

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Perforation of IVC by Chest Draings Tube -Report A Case (흉강삽관술시 하대정맥 천공 치험 1례)

  • Jeong, Won-Seok;Mun, Dong-Seok
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1128-1131
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    • 1997
  • Injuries to versa cave continue to be associated with a high mortality. Essentials to successful treatment are immediate recognition of the injury and prompt control of the hemorrhage. We have experienced one case of inferior versa java perforation by a chest rainage tube in the patient with post-operative chronic empyema thoracic. The patient was 38-year old male who was taken RLL lobectomy after 6 cycle of chemotherapy due to small cell carcinoma in the RLL & suffered from post-operative chronic empyema thoracis at D hospital. He moved to our hospital for further evaluation with accidental removal of chest drainge tube. We inserted closed drainage tube and dark blood gushed out abruptly just after insertion of the drainage tube. CTscan, MRI, and angiogram were performed and showed the perforation of IVC just below RA. The IVC was repaired using simple interrupted 4-0 Prolene suture through right posterolateral thoracotomy. The patient recovered without event and doing well until now.

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A Clinical Report of 9 Cases of Congenital Thyroid Dysgenesis (선천성 갑상선 발육이상 9례(例)에 대한 보고)

  • Lee Samuel;Lee Seug-Zae;Lee Hyouk-Jin;Chon Seong-Eun;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.206-211
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    • 1994
  • Congenital thyroid dysgenesis including agenesis, hypoplasia and ectopia is the predominant cause of permanent hypothyroidism. Of these, two thirds are due to an ectopic thyroid and about one third to complete thyroid agensis. From Jan. 1981 to Dec. 1992, authors experienced the 9 cases of congenital thyroid dysgenesis. Aberrent thyroid was 4 cases (44.4%), thyroid hemiagenesis with aberrent thyroid was 3 cases(33.3%) and thyroid hemiagenesis was 2 cases(22.2%). The most predominant site of aberrent thyroid is the base of tongue(85.7%). 7 patients(77.8%) revealed euthyroidism and among them, 4 patients showed elevated TSH level. Hypothyroidism was 2 patients (22.2%). 7 cases responded to thyroid suppressive therapy. 2 cases of lingual thyroid which did not responed to thyroid suppressive therapy underwent surgery and they have placed on thyroid suppressive therapy postoperatively.

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Invasive Thymoma Originating from Right Pleura with Normal Thymus A case Report (흉막에서 발생한 침습성 흉선종,정상 흉선을 가진 예)

  • 박희철;옥창석
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1381-1384
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    • 1996
  • Thymoma Is an anterior mediastinal tumor, arising from the thymus, but occasionally has ectopic focus such as neck, trachea, thyroid, pulmonary hilum, lung parenchyme and pleura. Forty-two year old male patient was admitted due to progressive development of shortness of breath in 4 months. He had a history of exposure to asbestos for About 10 years duration In recent 15 years. Radiologically, multiple pleural masses were seen rom apex to diaphrAgm, with no evidence of anterior mediastinal mass,with fluid in right pleural cavity. Closed thoracotomy drainage with open biopsy were performed. Effusion cell block showed many T cell marker positive Lymphocytes & some epithelial cells compatible with thymoma, and the tissue also showed cortical type thymoma. Pleuropneumonectomy and thymectomy followed by 60 Gy radiation therapy were done and the patient is well 8 months postoperatively. The pleura is markedly thickened by the invasion of thymoma and the interstitial space of the lung tissue,but the normal appearance of thymus was present in remote area (Masaoka classification IVa). We report a case of ectopic invasive thymoma arising from the right pleura with intact thymus.

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