• 제목/요약/키워드: Iliac

검색결과 540건 처리시간 0.032초

May-Thurner 증후군의 진단과 혈관내 치료 (Diagnosis and Endovascular Treatment of May-Thurner Syndrome)

  • 허균;이재욱;신화균;원용순
    • Journal of Chest Surgery
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    • 제37권11호
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    • pp.911-917
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    • 2004
  • 배경: 하지심부정맥 혈전증의 원인으로 알려져 있는 May-Thurner증후군(혹은 장골정맥 눌림증후군)의 임상 증상, 진단 및 혈관내 치료에 대해 분석하고자 하였다. 대상 및 방법: 2001년 3월부터 2003년 7월까지 May-Thurner증후군으로 진단 받은 12명의 환자들을 대상으로 하였으며 진단방법으로는 정맥조영술, 정맥초음파, 혈관조영 컴퓨터 단층촬영을 이용하였고 혈관내 시술은 혈전용해술, 혈전제거술, 혈관성형술, 혈관내 스텐트삽입 등을 시행하였다. 결과: 임상양상으로는 하지부종이 4예, 하지의 통증이 1예에서 보였으며 5예에서는 하지부종과 통증이 동반되었고 하지부종과 통증과 압통이 동반된 경우도 1예였다. 1예에서는 부종이나 통증은 없었으며 하지정맥류로 인해 시행한 정맥조영술에서 May-Thurner증후군이 발견되었다 진단방법으로는 임상양상과 더불어 1예를 제외하고는 모든 환자들이 정맥 조영술과 혈관조영 컴퓨터 단층촬영을 시행하였고 이중 4예에서는 정맥 초음파를 시행하였다. 혈관성형술을 11예에서 시행하였고, 혈관내 스텐트 삽입은 10예, 혈전 제거술은 9예, 혈전용해술은 7예에서 시행되었다. 9예에서 추적관찰을 하였고 이중 7예에서 혈관내 원활한 혈류의 흐름을 관찰할 수 있었다. 결론: 하지의 심부정맥 혈전증 환자에 있어서 May-Thurner증후군의 가능성을 충분히 인식하여야 하며 이의 진단을 위하여 다양한 방법이 필요하며 치료 방법으로는 혈관내 시술이 안전하면서 효과적이라고 생각된다.

대맥(帶脈) 및 그 유주상(流注上) 회합(會合)하는 경혈(經穴)에 대한 문헌적(文獻的) 고찰(考察) (Study on Dai Meridian(帶脈) and Meridian Points(經穴) of Joining with Circulation of Dai Meridian through Literatures of Every Generation)

  • 양승정;진천식;조명래
    • Korean Journal of Acupuncture
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    • 제18권1호
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    • pp.105-116
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    • 2001
  • We examined and referred to some literatures on the meaning, Dai meridian and Meridian points of joining with circulation of Dai meridian through literatures of every generation. And then we came to get a few conclusions as follows. 1. Dai meridian starts below the hypochondriac region. Running obliquely downward, it runs transversely around the waist like a belt. Its function is to bind up all the meridians to circulate in a proper way. 2. The coalescent points of dai meridian are $D\grave{a}im\grave{a}i$(帶脈), $W\check{u}sh\bar{u}$(五樞) and $W\acute{e}id\grave{a}o$(維道). 3. Location of $D\grave{a}im\grave{a}i$(帶脈) is on the lateral side of the abdomen, 1.8 cun below $Zh\bar{a}ngm\grave{e}n$(章門), at the crossing point of vertical line through the free end of the 11th rib and a horizontal line through the umbilicus. Location of $W\check{u}sh\bar{u}$(五樞) is on the lateral side of the abdomen, anterior to the anterosuperior iliac spine, 3 cun below the level of the umbilicus. Location of $W\acute{e}id\grave{a}o$(維道) is on the lateral side of the abdomen, anterior and inferior to the anterosuperior iliac spine, 0.5 cun anterior and inferior to $W\check{u}sh\bar{u}$(五樞). 4. Indication of $D\grave{a}im\grave{a}i$(帶脈) is irregular menstruation, leukorrhea with reddish discharge, hernia, pain in the lumbar and hypochondriac region. Indication of $W\check{u}sh\bar{u}$(五樞) is prolapse of the uterus, leukorrhea with reddish discharge, irregular menstruation, hernia, pain in the lower abdomen, constipation and lumbosacral pain. Indication of $W\acute{e}id\grave{a}o$(維道) is edema, pain in the side of the lower abdomen, prolapse of the uterus, hernia and morbid leukorrhea. 5. The Dai meridian binds all meridians, produces pregnancy, grasps lumbar and abdomen region and controls leukorrhea. 6. Diseases of the Dai meridian manifested as distention and fullness in the lumbar region and abdomen, leukorrhea with reddish discharge, pain the navel, lumbar and spinal regions, flaccidity and hypoactivity of the lower limbs, etc.

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하악골에 발생한 거대한 cemento-ossifying fibroma의 치험례 (A CASE REPORT OF THE HUGE CEMENTO-OSSIFYING FIBROMA OF THE MANDIBLE)

  • 이상철;김여갑;류동목;이백수;권용대;박종오
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권1호
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    • pp.70-75
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    • 2000
  • 본과에서는 하악에서 발생한 거대한 백악질-골성 섬유종에서 원발병소부위에 대한 광범위한 외과적 적출술 및 후방 장골이식을 통해 환자의 심미적, 기능적 안정성을 이루었으며 이환치아의 발거와 함께 술후 악간고정을 통하여 얇아진 하악하연부의 병적골절을 방지하였다. 현재까지 병소의 재발은 없고 양호한 결과를 보이고 있으며 향후 보철수복과 함께 지속적인 평가를 요할 것으로 사료된다.

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치료법을 달리한 상악골절후 부정유합 2예 (THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES)

  • 유재하;이원유;류수장
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제13권1호
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    • pp.117-127
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    • 1991
  • 현대 사회에서 외상의 특성은 다발성 손상이 빈발하는 것이며 상악골절시 생명을 위협하는 다발성 전신손상이 동반되면 수술이 지연되어 골절부의 지연된 부정유합을 보일 수 있다. 또한 골절된 양상에 따라서는 관혈적 정복술의 적용여부가 고려되는데 특히 골절편의 분쇄가 심하면 수술시 골절부위의 이개 후 정상위치로의 이동이 어렵고 설사 골절편의 이동이 이루어졌다고 하여도 정상위치로의 고정이 용이하지 않을 뿐만 아니라 분쇄골절편의 상실량이 많아지면 골이식까지 시행해야 하는 등 외과적이술식의 적용에 많은 난관이 예상된다. 따라서 상악골절 후 통상 6주일 간의 시간경과가 없다면 오히려 상악골절편의 이동방향을 예측하여, 전방견인용 headgear 또는 headcap 을 사용한 교정적인 치료를 시도함이 바람직할 수도 있다. 더우기 reverse headgear를 이용한 치료법은 골절된 경우가 아니더라도 상악골의 전방이동에 유용함이 실험적으로나 임상적으로 입증된 만큼 이를 상악골절후 후퇴된 상악골의 전방견인에 적용할 경우 교정치료의 최대장애인 cortical bone의 연속성이 골절로 인해 끊어지고 섬유성 유착상태로 남게되어 교정력의 효과가 치아이동 뿐만 아니라 골편의 이동에 매우 유익하리라 사료된다. 이에 저자는 상악골적이 분쇄양상인 한 환자에서 headgear와 headcap을 이용한 교정치료법을 5개월간 적용해 양호한 결과를 얻었고, 골절양상이 분쇄형이 아닌 증례에서는 외상후 5주간 경과 되었지만 관혈적 정복술을 시행하여 정상교합을 회복했으며, 심한 두부 손상으로 6개월만에 의식 회복을 한 LeFort I, II, III, 환자에서는 두부방사선 계측학적 분석, 교합기 상에서의 모형분석, 전산화 단층촬영 검사 등을 시행한 후 새로운 골면에다 LeFort I -osteotomy with iliac bone graft를 시행해 정상교합 및 안모추형을 개선시켰기에 이를 보고한다.

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Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

  • Kim, Sang-Yun;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.27.1-27.8
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    • 2018
  • Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

Mandibular reconstruction with a ready-made type and a custom-made type titanium mesh after mandibular resection in patients with oral cancer

  • Lee, Won-bum;Choi, Won-hyuk;Lee, Hyeong-geun;Choi, Na-rae;Hwang, Dae-seok;Kim, Uk-kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.35.1-35.7
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    • 2018
  • Background: After the resection at the mandibular site involving oral cancer, free vascularized fibular graft, a type of vascularized autograft, is often used for the mandibular reconstruction. Titanium mesh (T-mesh) and particulate cancellous bone and marrow (PCBM), however, a type of non-vascularized autograft, can also be used for the reconstruction. With the T-mesh applied even in the chin and angle areas, an aesthetic contour with adequate strength and stable fixation can be achieved, and the pores of the mesh will allow the rapid revascularization of the bone graft site. Especially, this technique does not require microvascular training; as such, the surgery time can be shortened. This advantage allows older patients to undergo the reconstructive surgery. Case presentation: Reported in this article are two cases of mandibular reconstruction using the ready-made type and custom-made type T-mesh, respectively, after mandibular resection. We had operated double blind peer-review process. A 79-year-old female patient visited the authors' clinic with gingival swelling and pain on the left mandibular region. After wide excision and segmental mandibulectomy, a pectoralis major myocutaneous flap was used to cover the intraoral defect. Fourteen months postoperatively, reconstruction using a ready-made type T-mesh (Striker-Leibinger, Freibrug, Germany) and iliac PCBM was done to repair the mandible left body defect. Another 62-year-old female patient visited the authors' clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular squamous cell carcinoma (SCC), reconstruction was done with a reconstruction plate and a right fibula free flap. Sixteen months postoperatively, reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair the mandibular defect after the failure of the fibula free flap. The CAD-CAM T-mesh was made prior to the operation. Conclusions: In both cases, sufficient new-bone formation was observed in terms of volume and strength. In the CAD-CAM custom-made type T-mesh case, especially, it was much easier to fix screws onto the adjacent mandible, and after the removal of the mesh, the appearance of both patients improved, and the neo-mandibular body showed adequate bony volume for implant or prosthetic restoration.

Inter-Rater Reliability of Abdominal Muscles Thickness Using Ultrasonography for Different Probe Locations and Thickness Measurement Techniques

  • Lim, One-Bin;Hong, Ji-A;Yi, Chung-Hwi;Cynn, Heon-Seock;Jung, Doh-Heon;Park, Il-Woo
    • 한국전문물리치료학회지
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    • 제18권4호
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    • pp.60-67
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    • 2011
  • Ultrasonography (US) is a recent technique that has proven to be useful for assessing muscle thickness and guiding the rehabilitation decision-making of clinicians and researchers. The purpose of this study was to determine the inter-rater reliability of the US measurement of transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) thicknesses for different probe locations and measurement techniques. Twenty healthy volunteers were recruited in this study. Muscle thicknesses of the transversus TrA, IO, and EO were measured three times in the hook-lying position. The three different probe locations were as follows: 1) Probe location 1 (PL1) was below the rib cage in direct vertical alignment with the anterior superior iliac spine (ASIS). 2) Probe location 2 (PL2) was halfway between the ASIS and the ribcage along the mid-axillary line. 3) Probe location 3 (PL3) was halfway between the iliac crest and the inferior angle of the rib cage, with adjustment to ensure the medial edge of the TrA. The two different techniques of thickness measurement from the captured images were as follows: 1) Muscle thickness was measured in the middle of the muscle belly, which was centered within the captured image (technique A; TA). 2) Muscle thickness was measured along a horizontal reference line located 2 cm apart from the medial edge of the TrA in the captured image (technique B; TB). The intraclass correlation coefficient (ICC [3,k]) was used to calculate the inter-rater reliability of the thickness measurement of TrA, IO and EO using the values from both the first and second examiner. In all three muscles, moderate to excellent reliability was found for all conditions (probe locations and measurement techniques) (ICC=.70~.97). In the PL1-TA condition, inter-rater reliability in the three muscle thicknesses was good to excellent (ICC=.85~.96). The reliability of all measurement conditions was excellent in IO (ICC=.95~.97). Therefore, the findings of this study suggest that TA can be applied to PL1 by clinicians and researchers in order to measure the thickness of abdominal muscles.

여자대학생의 생리주기에 따른 인체계측변인 둘레의 변화 (Changes in the girth of anthropometric variables during menstrual cycle in women university students)

  • 김영선;강설희;김윤정;박원엽;장지훈
    • 한국정보전자통신기술학회논문지
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    • 제14권5호
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    • pp.421-429
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    • 2021
  • 본 연구의 목적은 생리주기별로 인체계측변인의 둘레를 반복측정하고 둘레의 변화 정도를 제시하여 월경전 증후군 증상 경감을 위한 프로그램 및 보조물 개발, 월경기 여성건강관리프로그램 개발, 월경전기 및 월경기 여성을 위한 운동프로그램 개발 등에 기초자료를 제공하고자 하는 것이다. 연구참여자는 생리불순과 (속발성)월경곤란증, 월경전 증후군을 호소하지 않는 건강한 여자대학생 10명이었다. 생리주기별로 가슴부위(2곳)와 허리부위(2곳), 엉덩이 부위를 반복측정한 결과 겨드랑부위는 황체기에 비해 월경기에, 유두부 가슴둘레와 가는 허리둘레는 난포기에 비해 월경기에 유의하게 큰 결과를 보였다. 가슴둘레와 허리둘레에 있어 난포기와 황체기 사이에 유의한 차이가 없었으며, 엉덩이둘레는 생리주기에 따른 유의한 차이가 없었다. 결론적으로 가슴둘레와 허리들레는 생리주기에 따라 유의한 차이가 있었으며, 향후 체중, 체지방율, 혈중 및 국소호르몬 농도 변화 등을 중심으로 한 지속적인 연구수행이 제언된다.

골반교정에 대한 국내 임상 연구 동향 (An Overview of Clinical Studies on Pelvic Correction in Korea)

  • 백지유;배재룡;안훈모;이재흥
    • 대한의료기공학회지
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    • 제20권1호
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    • pp.118-147
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    • 2020
  • Objective : The purpose of this study is to understand trends of pelvic correction therapy in Korea and to assist research activities on pelvic correction therapy. Also, this study selected and presented indicators for measuring pelvic slope to help ensure consistent studies with uniform indicators in future studies related to pelvic correction. Methods : The following keywords "골반", "골반 교정", "골반 변위" "Pelvic correction" were searched on three specialized search sites (RISS, NAI, DBpia). Trends in pelvic correction therapy were analyzed through the selected researches suitable among these searched researches in an overview format. Results : 1. A total of 7,806 studies were searched and a total of 268 studies were finally selected. 2. Studies began in 1977 and have been actively studied until recently, with 35 studies in 2017 being the most recent trend since 2000. 3. In the results according to the Main Field of Research, the 'Arts and Kinesiology'(113, 42.16%) and 'Medicine and Pharmacy'(103, 38.43%) were the most in order. To the Middle Field, the 'Kinesiology was the largest with 96(35.82%) studies. 4. In the results according to the study design, 'Pre-Post Test(PPT)' was the largest with 107 studies. 5. In the results according to the Intervention, 'Exercise' was the largest with 165 studies, of which 'Pilates' and 'Yoga' in 'Training' was the largest. 6. Among the evaluation method, the 'Pelvic Index' was used 146 times, followed by 'Spinal Alignment (99)', 'Other Joints (93)', and 'Kinetic Specialized Measurement Test (56)'. 7. Among the evaluation methods, the pelvic slope measurement indicators were PT (58), PH (48), Pelvic Torsion (40), Iliac Crest (38), ASIS-PSIS distance/angle (27), and Pelvic Width (I.W., I.L., S.W) (25) in order. 8. The journals that published the most researches were KJSS(Korean Alliance For Health, Physical Education, Recreation, And Dance;9), and JKPT(Korean Physical Therapy;9). Among the University, the Graduate School of Silla University published the most papers (12). 9. The author who published the most studies were Seungjin Park(3), the co-authors were Hoseong Lee, Gideok Park, Seongsu Bae(3), and the Thesis-Director Gyeongok Lee(7). Conclusions : 1. Studies on pelvic correction treatment continue to increase every year. 2. The main academic field of pelvic correction is 'Sports', 'Physical Therapy', and 'Medical Science'. 3. The most chosen research design method in the study on pelvic correction treatment was 'Pre-Post Test(PPT)', primarily as an intermediary, Pilates and yoga during exercise therapy, and then Chiropractic during handcraft were used as multiple frequencies. 4. Among the various measurement method indicators of pelvic correction previously used, multiple frequency was taken up in the order of PT, PH, Pelvic Torsion, iliac crest, ASIS-PSIS distance/angle, and pelvic width (I.W.,I.L.,S.W). Typically, measurements through "ASIS-PSIS angle" are recommended and are considered as the most rational in clinical trials.

Portal vein reconstruction in pediatric liver transplantation using end-to-side jump graft: A case report

  • Jaewon Lee;Nam-Joon Yi;Jae-Yoon Kim;Hyun Hwa Choi;Jiyoung Kim;Sola Lee;Su young Hong;Ung Sik Jin;Seong-Mi Yang;Jeong-Moo Lee;Suk Kyun Hong;YoungRok Choi;Kwang-Woong Lee;Kyung-Suk Suh
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.313-316
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    • 2023
  • Attenuated portal vein (PV) flow is challenging in pediatric liver transplantation (LT) because it is unsuitable for classic end-to-end jump graft reconstruction from a small superior mesenteric vein (SMV). We thus introduce a novel technique of an end-to-side jump graft from SMV during pediatric LT using an adult partial liver graft. We successfully performed two cases of end-to-side retropancreatic jump graft using an iliac vein graft for PV reconstruction. One patient was a 2-year-old boy with hepatoblastoma and a Yerdel grade 3 PV thrombosis who underwent split LT. Another patient was an 8-month-old girl who had biliary atresia and PV hypoplasia with stenosis on the confluence level of the SMV; she underwent retransplantation because of graft failure related to PV thrombosis. After native PV was resected at the SMV confluence level, an end-to-side reconstruction was done from the proximal SMV to an interposition iliac vein. The interposition vein graft through posterior to the pancreas was obliquely anastomosed to the graft PV. There was no PV related complication during the follow-up period. Using a jump vascular graft in an end-to-side manner to connect the small native SMV and the large graft PV is a feasible treatment option in pediatric recipients with inadequate portal flow due to thrombosis or hypoplasia of the PV.