• Title/Summary/Keyword: 재절제

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The Result of Repeat Discectomy for Ipsilateral Recurrent Lumbar Disc Herniation (재발성 요추 추간판 탈출증에 대한 추간판 재절제술의 결과)

  • Kim, Woo-Sung;Na, Hwa-Yeop;Oh, Sang-Hoon;Park, Sub-Ri;Son, Eui-Young
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.59-64
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    • 2017
  • Purpose: To analyze the result of a repeat discectomy for ipsilateral recurrent lumbar disc herniation and to investigate the potential factors that influenced the outcomes for this surgery. Materials and Methods: Fifty-nine patients, who underwent reoperation after lumbar discectomy with a minimum follow-up period of 2 years, were reviewed. The surgical outcome was assessed using the visual analogue scale (VAS) and Macnab classification, and the recovery rate was calculated in accordance with VAS. A statistical analysis was carried out by SPSS to evaluate the possible factors that may have influenced the outcomes of the reoperation. Results: The rate of reoperation after lumbar disc surgery due to the recurrent disc herniation was 6.0% (59/983 cases). The average recovery rate of VAS from the 1st operation was approximately 77%, and from the 2nd operation was 71%. According to the Macnab criteria, the results were "excellent" or "good" in 96% of cases. Statistical analysis revealed that there was no difference of the average recovery rate (p<0.05). There is no additional instability after repeat discectomy. Factors, such as smoking, precipitating traumatic events, and diabetes mellitus did not have much influence on the average recovery rate after repeat discectomy for ipsilateral recurrent lumbar disc herniation. Conclusion: The outcomes of repeat discectomy were satisfactory. Moreover, factors, smoking, trauma history and diabetic mellitus, only had a minor impact on the outcomes of a repeat discectomy.

Unplanned Excision of Soft Tissue Sarcoma: Patient Profile and Treatment Outcomes (연부 조직 육종에 대한 무계획적 절제술: 환자의 임상적 특징 및 치료 결과)

  • Lee, Jae Hoo;Cho, Yong Jin;Kim, Seung Hyun;Shin, Kyoo Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.72-77
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    • 2012
  • Purpose: Unplanned excision of a soft tissue sarcoma is defined as the operation performed for gross removal of a soft tissue sarcoma without regard for preoperative imaging or the necessity to removal a margin of normal tissue covering the cancer. We report our experience of treating primary soft tissue sarcoma after an unplanned excision. Materials and Methods: We retrospectively reviewed 31 patients referred to our hospital after unplanned excision at other hospitals for treatment of a STS. The clinical information was reviewed with a focus on the patient's age, gender, tumor location, tumor size, tumor depth, presumptive diagnoses at the previous surgery, refer hospital, definitive diagnosis, interval between the initial and additional surgery and local recurrence. Results: There were 19 males and 12 females with a median age of 48 years (range, 17-75 years) at the time of referral. Seventeen patients (54.8%) had tumors in their lower limb, 6 (19.4%) had tumors in their upper limb, and 8 (25.8%) had tumors in their trunk. Tumor depth could be determined for 8 patients (25.8%), with superficial and 22 deep tumors (71%). The medial interval between unplanned excision to re-excision ranged from 2 weeks to 1 year (median, 5 weeks). Local recurrence was detected in 2 patients. All patients were alive without metastasis at last follow up. Conclusion: Even in upper class general hospital, many unplanned excision had been performed, which is considered to be avoided. When the relatively huge mass located in deeper layer it requires enough preoperative imaging studies and biopsy.

Clinical Approach for Thyroid Radiofrequency Ablation (갑상선 고주파 절제술을 위한 임상진료)

  • Jung Suk Sim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1017-1030
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    • 2023
  • Radiofrequency ablation (RFA) is a non-surgical treatment for symptomatic, benign thyroid nodules. This treatment works by heating and destroying the nodule tissue, which results in reduction of its size and alleviation of the symptoms involved. RFA is indicated for nodules which are confirmed to be benign on two or more cytological or histological examinations, and which result in clinical symptoms requiring medical treatment. It is associated with good short-term outcomes on one-year follow-up; however, 20%-30% of the nodules regrow after more than three years. Therefore, on the basis of long-term follow-up, management of regrowth is key to patient care following RFA. Regrowth is more likely to occur in nodules that are large in size prior to RFA, and in those with high or increased vascularity. Recently, new techniques such as hydrodissection, artery-first ablation, and venous ablation have been introduced to inhibit regrowth. In addition, appropriate criteria for additional RFA should be applied to manage regrowth and prolong its therapeutic effects. RFA is essentially an alternative to surgery; therefore, the ultimate goal of this procedure is to avoid surgery permanently, rather than to achieve temporary effects.

Segmental Resection and Replantation for Primary Malignant or Aggressive Tumors of the Upper Limb (상지에 발생한 악성 및 침윤성 종양의 분절절제 및 재접합술)

  • Hahn, Soo-Bong;Lee, Woo-Suk;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.10-16
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    • 2000
  • Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

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대두 이소플라본과 골조직의 대사(Bone turnover)

  • Kim, Seong-Ran
    • Bulletin of Food Technology
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    • v.15 no.1
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    • pp.16-26
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    • 2002
  • 이 논문은 대두 이소플라본 섭취가 난소를 절제한 쥐의 골격 손실에 미치는 영향을 투여량에 따라 조사한 것이다. 실험 초기에 암컷의 Wistar rats(7개월령; n=55)을 절제 후 봉합시킨 군(SH; n=14)과 난소절제군(OVX; n=41)으로 각각 구분하여 사육하고 80일 후에 각 5마리씩을 해부하여 난소절제로 인한 골손실 진행여부를 확인하였다. 그 후 난소절제 쥐(OVX)를 9마리씩 4그룹으로 나누고 대두 이소플라본(IF, 대두단백질이 없는 실험식이에 혼합하여 공급)을 각각 0, 20, 40, 80mg/ (kg body.d)씩 84일간 공급하였다. 동시에 SH rats에게도 이소플라본이 없는 실험식이를 섭취시켰으며 164일 후에 해부하였다. 예상했던 대로 골 무기질 밀도(대퇴골, 골간부위와 골간단부위) 및 골 표면적에 대한 다공성 골 면적의 비(대퇴골 원위부 골간단에서)가 OVX군이 SH군보다 낮았다(P<0.05). OVX군은 SH군보다 혈장 osteocalcine 농도가 높았으며 소변으로의 deoxypyridinoline 배설량이 많았다(P<0.05). 164일째 osteocalcine 과 deoxypyridinoline 농도는 OVX군에서보다 IF40 및 IF80군에서 더 낮았다(P<0.05). 그럼에도 불구하고 골 무기질 밀도와 다공성 골 면적이 OVX군에서보다 IF군들에서 더 낮아지지는 않았다. 그러므로 난소를 절제한 성숙한 쥐에게 대두 이소플라본을 매일 섭취시키는 것은 골격조직의 재흡수를 감소시킬 수 있으나 이미 진행된 골감소증(osteophenia)을 회복시킬 수는 없는 것으로 나타났다.

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Arthroscopic Technique of Partial Meniscectomy for Bucket Handle Tear of Medial Meniscus using Posteromedial Portal (내측 반월상 연골판 양동이형 파열의 후내측 도달법을 이용한 관절경적 부분 절제술 - 수술 수기 -)

  • Ahn, Jin-Hwan;Lee, Jong-Yoon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.71-75
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    • 2000
  • Purpose : To introduce arthroscopic partial meniscectomy fur bucket handle tear of medial meniscus using posteromedial portal, which is superior to arthroscopic partial meniscectomy using standard anterior portals commonly used. Method : After arthroscopic examination of the knee, we reduce the torn meniscus, advance the arthroscope into posteromedial compartment under arthroscopic visualization, we make posteromedial portal with reexamination of the compartment and perform arthroscopic partial meniscectomy. Conclusion : With the technique of arthroscopic partial meniscectomy using standard anterior portals, accurate partial meniscectomy can not be done because of inadequate visual field, associated meniscal injuries of posterior horn and cartilage lesion of posterior aspect of the medial femoral condyle can be missed, commonly posterior cruciate ligament can be injured and artificial damage to weight bearing surface of medial femoral condyle is possible. An arthroscopic partial meniscectomy using posteromedial portal is an excellent method fur bucket handle tear of medial meniscus.

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Clinical Results of Silicone Oil Injection following Vitrectomy as a Primary Procedure in Retinal Detachment (망막박리에서 일차수술로 유리체절제술과 실리콘 주입술에 대한 임상결과 분석)

  • Gyeong, Gil-Hyeon;Lee, Moo-Sik;Hwang, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3919-3924
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    • 2009
  • To evaluate clinical results of silicone oil injection for retinal detachment. The 45 eyes of 44 patients underwent vitrectomy and silicone oil injection from 1999 to 2002. 1.There were no history of previous retinal surgery and ocular trauma. In 24 of the 45 eyes(53%) visual acuity increased and stabilized in 18 of the 45 eyes(40%). 2. 1 of 16 eyes(6.3%) had recurred retinal detachment after silicone oil removal. 3. Final retinal reattachment was achieved in 44 eyes(97%). Postoperative complications were cataract(16 eyes), glaucoma(10 eyes), emulsification of silicone oil(5 eyes), keratopathy(2 eyes) and recurrent retinal detachment(1 eye). These results show that silicone oil injection for primary retinal detachment yields a high rate of anatomic success and the good visual outcome

Clinical Results of Silicone Oil Injection following Vitrectomy as a Primary Procedure in Retinal Detachment Patients (망막박리(網膜剝離)에서 일차수술(一次手術)로 유리체절제술(節制術)과 실리콘기름 주입술(注入術)을 시행한 환자(患者)의 임상결과(臨床結果))

  • Gyeong, Gil-Hyeon;Lee, Moo-Sik;Na, Bak-Ju;Kim, Chul-Woung;Hwang, Hye-Jeong
    • Proceedings of the KAIS Fall Conference
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    • 2009.05a
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    • pp.612-615
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    • 2009
  • 본 연구는 망막수술의 기왕력이 없고 고식적인 수술방법으로는 예후가 나쁠 것으로 예상되는 망막박리에서 유리체절제술과 일차적으로 실리콘 기름을 사용했을 경우의 초기적용의 유용성 및 합병증을 알아보고자 망막박리로 유리체절제술과 실리콘기름주입술을 시행하고 6개월 이상 추적관찰이 가능한 환자 44명을 대상으로 연구하였다. 결과는 다음과 같다. 1. 유리체절제술 후 시력이 두 줄 이상 호전된 경우는 45안 중 24안(53%)이었으며, 18안(40%)에서는 시력의 변화가 없었다. 2. 실리콘기름주입술 후 16안에서 평균 6.9개월에 실리콘기름을 제거하였으며 그 중 1안에서 망막박리가 재발되어 실리콘기름 재주입술을 시행하여 망막재유착을 이루었다. 3. 재수술을 포함하여 해부학적인 재유착은 45안 중 44안(97%)에서 이루었다. 4. 실리콘기름주입 후 발생한 합병증은 백내장(16안), 녹내장(10안), 실리콘기름의 유화(5안), 각막병증(2안), 재발성 망막박리 (1안)이었다.

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