• 제목/요약/키워드: Malposition

검색결과 106건 처리시간 0.025초

Can Right-Handed Surgeons Insert Upper Thoracic Pedicle Screws in much Comfortable Position? Right-Handedness Problem on the Left Side

  • Akyoldas, Goktug;Senturk, Salim;Yaman, Onur;Ozdemir, Nail;Acaroglu, Emre
    • Journal of Korean Neurosurgical Society
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    • 제61권5호
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    • pp.568-573
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    • 2018
  • Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

조밀화 집합체로 중간저장하는 경우 원자력 발전소 9, 10호기의 사용 후 핵연료 저장조의 임계분석 (The Criticality Analysis of Spent Fuel Pool with Consolidated Fuel in KNU 9 & 10)

  • Jae, Moo-Sung;Park, Goon-Cherl;Chung, Chang-Hyun;Jang, Jong-Hwa
    • Nuclear Engineering and Technology
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    • 제20권1호
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    • pp.27-34
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    • 1988
  • 1990년 중반에는 우리나라 모든 원자력 발전소의 사용 후 핵연료 저장조의 용량부족이 예견된다. 따라서 조밀화 집합체로 저장하는 MDR 방법을 가장 저장용량이 적은 9, 10호기 원전의 저장용량을 확장시키는데 적용하고자 하였다. 이러한 방법을 채택할 때 9,10원전의 사용후 핵연료 저장조의 안전성을 확인하기 위해 격자 간격과 저장통 두께를 변화시키면서 중성자 증배계수를 AMPX-KENO IV코드로 계산하였다. 그리고 이 전산체제를 검증하기 위해 1981년 B & W에서 실시한 임계실험에 대하여 검증계산을 수행하였다. 또한 가상사고로써 malposition사고도 모사하였다. 그 결과, 원전 9, 10호기의 핵연료 조밀화 저장법은 안전하며, 설비 및 냉각공간을 고려하여 9/3 노심분을 27/3 노심분의 저장 용량으로 확장할 수 있을 것이다.

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위치이상 치아의 치은 성형을 동반한 심미적 보철수복 (Esthetic restoration of malpositioned anterior teeth by tooth shape and gingival contour modification : a clinical report)

  • 김자영;김경아;서재민
    • 구강회복응용과학지
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    • 제31권2호
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    • pp.143-149
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    • 2015
  • 전치부는 심미적인 관점에서 치열 및 연조직과의 조화가 매우 중요하다. 상악 전치부의 심미적인 치료는 술 전 정확한 진단과 치료계획이 필수적인데 술자는 특히 치관부 크기의 적절한 비율과 치은 형태의 대칭에 대해 충분히 고려해야 한다. 만약 치은의 형태가 비심적이고 부자연스러운 경우에는 치은 절제술, 골삭제를 동반한 치관 연장술, 교정적 정출술 등을 시행할 수 있다. 치관의 형태 및 위치가 부적절한 경우에는 술 전 진단 모형 및 왁스 업을 통해 교정 치료나 완전도재관, 라미네이트 베니어 등의 심미적 보철치료를 계획할 수 있다. 본 증례들에서는 치아의 위치 이상과 연,경조직의 부조화를 가진 전치부를 교정 치료 및 치은 성형과 심미적 보철 치료를 시행함으로써 만족할만한 결과를 얻었기에 이를 보고하고자 한다.

누두흉의 수술적 교정 (Surgical Repair of Pectus Excavatum)

  • 조덕곤
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.1027-1034
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    • 1990
  • Pectus excavatum, commonest developmental anomaly of chest wall, is manifested by depression of the sternum and lower costal cartilages that is of surgical interest. From 1982 through 1990, fifteen patients have undergone surgery for treatment of pectus excavatum and treated by Ravitch operation: 5, Modified Ravitch operation; 4, Wada operation, 1 and Modified Wada operation, 5. There was familial history of pectus excavatum in 3 patients. Associated congenital anomaly were seen in 6 patients; scoliosis in 3 patients, right inguinal hernia in 1, polydactyly in 1 and patent ductus arteriosus in 1 patent. Postoperative minor complications were developed in 3 cases; pneumothorax, 2 cases; pleural effusion, 2 cases; wound infection and dehiscence, 1 cases; pressure sore due to strut malposition, 2 cases; flail chest and 2 cases; seroma. The incidence of the postoperative complications were more common in cases who were treated by metal strut, pin or other prosthetic materials for supporting the chest wall integrity than the standard corrective procedure. All cases have no recurrence of chest wall depression and operative death.

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Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

  • Kim, Dongmin;Lim, Seong-Hoon;Seo, Pil Won
    • Journal of Chest Surgery
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    • 제46권3호
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    • pp.223-225
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    • 2013
  • Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

A Diagnostic Imaging Case of Cervical Spinal Subluxation for Chuna Mannual Therapy: Cervical Malposition with OPLL

  • Na, Hyun-Jong;Chang, Seok-Gon
    • 대한한의학회지
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    • 제37권4호
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    • pp.45-48
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    • 2016
  • Objectives: A diagnostic imaging in a fifty five year-old woman diagnosed orthopedically as ossification of posterior longitudinal ligament (OPLL) at C5 and C6 levels was reinterpreted for Chuna mannual therapy. The cervical spinal lesion in simple X-ray and CT scan images was discussed by spinal listing systems and disc block subluxation theory. The primary adjustive target was C4 disc block subluxation, which had been affected by kyphosis. Chuna manual therapy based on diagnostic images could be helpful for adjusting spinal subluxation, correcting its adaptation curvature, and preventing its latent pathology efficiently.

가족성 거대 백악종 (Familial gigantiform cementoma)

  • 한원정;김은경
    • Imaging Science in Dentistry
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    • 제36권3호
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    • pp.157-162
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    • 2006
  • Familial gigantiform cementoma is a rare fibre-cemento-osseous disease of the jaws which appears to be transmitted as an autosomal dominant trait with variable expressivity of the phenotype. A 7-year-old girl visited DKUDH complaining of the painless facial deformity. Clinically, significant facio-lingual expansion was observed at the left maxilla, left mandibular body and symphysis portion. Malposition of lower anterior teeth was found. Panoramic radiograph and CT scan showed the extensive expansile mixed lesion at maxilla and mandible. Bone scan revealed hot spot at the maxilla and left side of mandible. Histologic examination revealed moderately dense fibrous connective tissue with scattered masses resembling cementum. The patient's mother had a history of the mandibular resection due to benign tumor. Her younger brother had buccal expansion of right mandible. We report our finding of a family that has exhibited clinical, radiographic and histologic findings consistent with the familial gigantiform cementoma.

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큰 중족골 내전각을 가지는 무지외반증에 대한 간단한 교정 방법 (Technique Tip: A Simple Method to Treat Hallux Valgus with Severe Metatarsus Adductus)

  • 박철현;최영화;박정진
    • 대한족부족관절학회지
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    • 제23권2호
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    • pp.78-81
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    • 2019
  • Hallux valgus with metatarsus adductus is difficult to treat and has a higher risk of recurrence after correction. Some treatments for hallux valgus with metatarsus adductus have been reported, but these are extensive procedures with a risk of complications associated with the shortening and malposition of the lesser metatarsals. The technique described here is easier to perform and has several advantages over the previously reported techniques.

만성 슬개대퇴통증 환자에 턱관절균형요법을 병용하여 증상 개선을 보인 치험 1례 (Case Report of a Patient Who Experienced Symptomatic Improvement Using Combined TMJ Balancing Therapy to Chronic Patellofemoral Pain)

  • 최가원
    • 턱관절균형의학회지
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    • 제13권1호
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    • pp.27-31
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    • 2023
  • The purpose of this case report is to introduce a case of immediate results with TMJ balancing therapy (TBT) in the treatment of chronic patellofemoral pain (PFP). A 17-year-old female patient with 4-month-old chronic knee pain that was unresponsive to conventional treatment was treated with TBT for a total of 5 sessions. The primary outcomes were evaluated using the Numeric Rating Scale (NRS) and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC). Following the first treatment, the NRS decreased rapidly, and the KWOMAC improved after a total of five treatments. These findings suggest that TBT can be an effective pain management option for chronic PFP patients with temporomandibular joint malposition. However, as this study is a report of a single case, further research is necessary.

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