• 제목/요약/키워드: Entry lesions

검색결과 14건 처리시간 0.022초

Inferolateral Entry Point for C2 Pedicle Screw Fixation in High Cervical Lesions

  • Lee, Kwang-Ho;Kang, Dong-Ho;Lee, Chul-Hee;Hwang, Soo-Hyun;Park, In-Sung;Jung, Jin-Myung
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.341-347
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    • 2011
  • Objective : The purpose of this retrospective study was to evaluate the efficacy and safety of atlantoaxial stabilization using a new entry point for C2 pedicle screw fixation. Methods : Data were collected from 44 patients undergoing posterior C1 lateral mass screw and C2 screw fixation. The 20 cases were approached by the Harms entry point, 21 by the inferolateral point, and three by pars screw. The new inferolateral entry point of the C2 pedicle was located about 3-5 mm medial to the lateral border of the C2 lateral mass and 5-7 mm superior to the inferior border of the C2-3 facet joint. The screw was inserted at an angle $30^{\circ}$ to $45^{\circ}$ toward the midline in the transverse plane and $40^{\circ}$ to $50^{\circ}$ cephalad in the sagittal plane. Patients received followed-up with clinical examinations, radiographs and/or CT scans. Results : There were 28 males and 16 females. No neurological deterioration or vertebral artery injuries were observed. Five cases showed malpositioned screws (2.84%), with four of the screws showing cortical breaches of the transverse foramen. There were no clinical consequences for these five patients. One screw in the C1 lateral mass had a medial cortical breach. None of the screws were malpositioned in patients treated using the new entry point. There was a significant relationship between two group (p=0.036). Conclusion : Posterior C1-2 screw fixation can be performed safely using the new inferolateral entry point for C2 pedicle screw fixation for the treatment of high cervical lesions.

Clinical and Pathological Aspects of Filarial Lymphedema and Its Management

  • Shenoy, R.K.
    • Parasites, Hosts and Diseases
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    • 제46권3호
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    • pp.119-125
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    • 2008
  • Lymphatic filariasis, transmitted by mosquitoes is the commonest cause of lymphedema in endemic countries. Among 120 million infected people in 83 countries, up to 16 million have lymphedema. Microfilariae ingested by mosquitoes grow into infective larvae. These larvae entering humans after infected mosquito bites grow in the lymphatics to adult worms that cause damage to lymphatics resulting in dilatation of lymph vessels. This earliest pathology is demonstrated in adults as well as in children, by ultrasonography, lymphoscintigraphy and histopathology studies. Once established, this damage was thought to be irreversible. This lymphatic damage predisposes to bacterial infection that causes recurrent acute attacks of dermato-lymphangio-adenitis in the affected limbs. Bacteria, mainly streptococci gain entry into the lymphatics through 'entry lesions' in skin, like interdigital fungal infections, injuries, eczema or similar causes that disrupt integrity of skin. Attacks of dermato-lymphangio-adenitis aggravates lymphatic damage causing lymphedema, which gets worse with repeated acute attacks. Elephantiasis is a late manifestation of lymphatic filariasis, which apart from limbs may involve genitalia or breasts. Lymphedema management includes use of antifilarial drugs in early stages, treatment and prevention of acute attacks through 'limb-hygiene', antibiotics and antifungals where indicated, and physical measures to reduce the swelling. In selected cases surgery is helpful.

Morphometric Relationship between the Cervicothoracic Cord Segments and Vertebral Bodies

  • Kim, Ji Hoon;Lee, Chul Woo;Chun, Kwon Soo;Shin, Won Han;Bae, Hack-Gun;Chang, Jae Chil
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.384-390
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    • 2012
  • Objective : The objective of this study was to investigate the morphologic characteristics between the vertebral body and the regions of the cervical and thoracic spinal cords where each rootlets branch out. Methods : Sixteen adult cadavers (12 males and 4 females) with a mean age of 57.9 (range of 33 to 70 years old) were used in this study. The anatomical relationship between the exit points of the nerve roots from the posterior root entry zone at each spinal cord segment and their corresponding relevant vertebral bodies were also analyzed. Results : Vertical span of the posterior root entry zone between the upper and lower rootlet originating from each spinal segment ranged from 10-12 mm. The lengths of the rootlets from their point of origin at the spinal cord to their entrance into the intervertebral foramen were 5.9 mm at the third cervical nerve root and increased to 14.5 mm at the eighth cervical nerve root. At the lower segments of the nerve roots (T3 to T12), the posterior root entry zone of the relevant nerve roots had a corresponding anatomical relationship with the vertebral body that is two segments above. The posterior root entry zones of the sixth (94%) and seventh (81%) cervical nerve roots were located at a vertebral body a segment above from relevant segment. Conclusion : Through these investigations, a more accurate diagnosis, the establishment of a better therapeutic plan, and a decrease in surgical complications can be expected when pathologic lesions occur in the spinal cord or vertebral body.

척수 손상 환자의 중추성 통증에 대하여 시행한 Microsurgical DREZotomy의 효과 (Microsurgical DREZotomy for Treatment of Intractable Central Pain in Patient with Spinal Cord Injury)

  • 이지인;김성호;안상호;장성호
    • Journal of Yeungnam Medical Science
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    • 제19권1호
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    • pp.49-54
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    • 2002
  • 척수손상 환자에게 동반되는 통증은 흔하지만 치료에 잘 반응하지 않고 환자들의 일상생활에 더욱 장애를 줄 수 있는 합병증의 하나로 알려져 있다. 3년 전 외상성 척수손상으로 인하여 불완전 하지 마비 소견을 보였던 52세 된 남자 환자로 손상 직후부터 발생된 양측 T10위치의 분절통과 손상 1개월 후부터 발생된 양하지 통증이 있어 약물요법, 물리치료, 및 운동치료 등의 여러 가지 치료를 시행하였으나 치료에 잘 반응하지 않아 DREZ(Dorsal Root Entry Zone)otomy 수술을 시행한 후 분전통이 호전된 증례가 있어 이를 보고하고자 하였다. 보존적 치료에 잘 반응하지 않는 척수손상 후 통증의 경우 DREZotomy 수술도 도움이 될 것으로 사료된다.

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Cerebral Infarction Mimicking Skeletal Metastases on Tc-99m MDP Bone Scintigraphy

  • Lim, Seok-Tae;Park, Soon-Ah;Sohn, Myung-Hee;Yim, Chang-Yeol
    • 대한핵의학회지
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    • 제34권5호
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    • pp.433-435
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    • 2000
  • A 6000-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the ether represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.$^{1-4)}$ A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.$^{4)}$ Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.

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뇌부종(腦浮腫)을 동반한 대뇌(大腦)의 결핵종(結核腫) 1례(例) (A Case of Tugerculoma in Cerebrum with Brain Edema)

  • 손동혁;유경숙;장인수;이영구;윤희식;변덕시;이진구
    • 대한한방내과학회지
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    • 제21권3호
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    • pp.529-533
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    • 2000
  • Intracranial tuberculoma is very rare nowadays. It is very difficult to differentiate tuberculoma from other space-occupying lesions. CT and MRI and intensive systemic review is very useful to diagnose intracranial tuberculoma. This case of patient had several symptoms of hemiparesis, headache. And we supposed that his symptoms were due to cerebrovascular accident at entry. But he was diagnosed as tuberculoma with brain edema in cerebrum. After treating him with mannitolization, acupuncture and herb medicine, his symptoms were remarkably improved. So we report this case of tuberculoma in cerebrum.

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삼첨판막 폐쇄부전을 동반한 선천성 교정형 대혈관전위증치험 1례 보 (Corrected transposition of the great arteries associated with severe tricuspid insufficiency: one case report)

  • 김치경;나범환;이홍균
    • Journal of Chest Surgery
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    • 제17권3호
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    • pp.362-370
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    • 1984
  • The term corrected transposition of great arteries [hereafter referred to as corrected TGA] of the heart in which there is both a discordant atrio-ventricular relationship and transposition of the great vessels. Usually situs solitus is present, while the ventricles are inverted showing an l -loop. The great vessels are transposed and in the l-position so that the pulmonary artery arises from the right-sided morphological left ventricle and the anteriorly l- transposed aorta arises from the left-sided morphological right ventricle yielding an SLL pattern. In the majority of cases, associated lesions are common. The most frequent are ventricular septal defect, obstruction to the pulmonary outflow tract, tricuspid valve incompetence and atrio-ventricular conduction abnormalities. In the rare cases, no associated conditions are present and hemodynamic pathways are normal. In the report, we present one case of a 20 year-old male having corrected TGA associated with severe tricuspid valve incompetence, was corrected by tricuspid valve replacement, directly developed a supra-ventricular tachycardia but was controlled by calcium-entry blocker, verapamil, successfully.

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진균증을 치료하는 한방외용약의 제형과 약물 분류 (Study on The Herbs and Forms of Oriental Applications to Treat Mycoses)

  • 김용찬;강정수
    • 동의생리병리학회지
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    • 제20권5호
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    • pp.1126-1134
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    • 2006
  • Human fungal infections are uncommon in normally healthy persons, being confined to conditions such as candidiasis (thrush) and dermatophyte skin infections such as athlete's foot. However, in the immunocompromised host, a variety of normally mild or nonpathogenic fungi can cause potentially fatal infections. Furthermore, the relativeease with which people can now visit 'exotic' countries provides the means for unusual fungal infections to be imported into this country. Mycoses appear in many different forms and areas. Fungal infections or mycoses are classified depending on the degree of tissue involvement and mode of entry into the host. These are Cutaneous, Subcutaneous, Systemic, and Opportunistic. Cutaneous mycoses specially appears symptoms on the skin. They are treated by amphotericinB, nystatin, grycelfulvin, micronazole and ketaconazole, etc, but these medicines are been careful about using, because most of them have serious side effects and toxicities. So, on the purpose of finding safe novel medicines, we have researched oriental medicines and search them to treat mycoses. In oriental medicines treating mycoses, we pay attention to orient applications that directly have an effect on disorder lesions. Oriental applications consists of various herbs and have a lot of forms, so we try to classify them as herbs and forms

Next-Generation Frozen Elephant Trunk Technique in the Era of Precision Medicine

  • Suk-Won Song;Ha Lee;Myeong Su Kim;Randolph Hung Leung Wong;Jacky Yan Kit Ho;Wilson Y. Szeto;Heinz Jakob
    • Journal of Chest Surgery
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    • 제57권5호
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    • pp.419-429
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    • 2024
  • The frozen elephant trunk (FET) technique can be applied to extensive aortic pathology, including lesions in the aortic arch and proximal descending thoracic aorta. FET is useful for tear-oriented surgery in dissections, managing malperfusion syndrome, and promoting positive aortic remodeling. Despite these benefits, complications such as distal stent-induced new entry and spinal cord ischemia can pose serious problems with the FET technique. To prevent these complications, careful sizing and planning of the FET are crucial. Additionally, since the FET technique involves total arch replacement, meticulous surgical skills are essential, particularly for young surgeons. In this article, we propose several techniques to simplify surgical procedures, which may lead to better outcomes for patients with extensive aortic pathology. In the era of precision medicine, the next-generation FET device could facilitate the treatment of complex aortic diseases through a patient-tailored approach.

TLR9 Expression in Uterine Cervical Lesions of Uyghur Women Correlate with Cervical Cancer Progression and Selective Silencing of Human Papillomavirus 16 E6 and E7 Oncoproteins in Vitro

  • Hao, Yi;Yuan, Jian-Ling;Abudula, Abulizi;Hasimu, Axiangu;Kadeer, Nafeisha;Guo, Xia
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5867-5872
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    • 2014
  • Background: Cervical cancer is listed as one of high-incidence endemic diseases in Xinjiang. Our study aimed to evaluate the expression of TLR9 in uterine cervical tissues of Uyghur women and examine associations with clinicopathological variables. We further characterized the direct effects of TLR9 upon the selective silencing of human papillomavirus (HPV) E6 and E7 oncoprotein expression in HPV 16-positive human cervical carcinoma cells treated with siRNA in vitro. Materials and Methods: Immunohistochemistry was applied to evaluate TLR9 expression in 97 formalin-fixed paraffin-embedded cervical samples from Uyghur women; 32 diagnosed with cervical squamous cell carcinomas (CSCC), 14 with low-grade cervical intraepithelial neoplasias (CINI), 10 medium-grade (CINII), 24 high-grade (CINIII), and 17 chronic cervicitis. $BLOCK-iT^{TM}$ U6 RNAi Entry Vector $pENTR^{TM}$/U6-E6 and E7 was constructed and transfected the entry clone directly into the mammalian cell line 293FT. Then the HPV 16-positive SiHa human cervical carcinoma cell line was infected with RNAi recombinant lentivirus. RT-PCR and Western blotting were used to determine the expression of TLR9 in both SiHa and HPV 16 E6 and E7 silenced SiHa cells. Results: Immunohistochemical staining showed that TLR9 expression was undetectable (88.2%) or weak (11.8%) in chronic cervicitis tissues. However, variable staining was observed in the basal layer of all normal endocervical glands. TLR9 expression, which was mainly observed as cytoplasmic staining, gradually increased in accordance with the histopathological grade in the following order: chronic cervicitis (2/17, 11.8%)