• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.110-119
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• 2021

Objective : Preoperative prediction of the arachnoid membrane descent in pituitary surgery is useful for achieving gross total removal and avoiding cerebrospinal fluid leakage resulting from tearing of the arachnoid membrane in the chiasmatic cistern. In this study, we analyzed the patterns of arachnoid membrane descent during or after pituitary tumor surgery and identified the factors related to this descent. Methods : Analysis was restricted to pituitary macroadenomas not extending into the third ventricle or over the internal carotid artery. To minimize confounding factors, patients who underwent revision surgery, those who had a torn arachnoid during operation or small medial diaphragma sellae (DS) opening, and subtotal resections were excluded. We enrolled 41 consecutive patients in this retrospective analysis. The degree of arachnoid descent was categorized using intraoperative videos. Preoperative magnetic resonance findings, including tumor height, suprasellar extension, and variables including DS area and medial opening size, tumor composition, and displacement of the pituitary stalk and gland were evaluated to determine their correlations with arachnoid membrane descent. Results : Arachnoid membrane descent was significantly correlated with DS area and medial opening size. Based on T2-weighted images (T2WI) magnetic resonance (MR) images, tumor composition was significantly associated with arachnoid membrane descent. Other factors were not significantly correlated with arachnoid membrane descent. Conclusion : T2WI of tumor composition and preoperative MR imaging of DS area and medial opening provided valuable information regarding arachnoid membrane descent. These parameters may serve as fundamental measures to facilitate complete resection of pituitary macroadenomas.

• Knee surgery & related research
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• 제30권4호
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• pp.364-368
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• 2018

We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.

• Journal of Oral Medicine and Pain
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• 제38권2호
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• pp.143-147
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• 2013

측두하악장애 중 개구제한은 일반적으로 저작근, 측두하악관절의 통증, 비정복성 관절원판변위, 측두하악관절의 유착이나 강직, 저작근의 근경축 등에 의해 발생한다. 하지만 이비인후과적인 질환, 신경 및 혈관질환, 종양, 염증, 감염 등에 의해 측두하악장애와 유사한 통증 및 개구제한이 유발 될 수 있다. 따라서 병력 조사 및 임상 검사 시 이러한 이차적 질환에 대한 고려가 필요하다. 특히 초진 시 전형적인 측두하악장애의 소견을 보인다고 할지라도 적절한 치료 및 환자의 자기 관리에도 불구하고 증상의 호전이 없거나 지속적인 악화 소견을 보이는 경우에는 염증, 감염, 종양 등의 가능성에 관한 포괄적인 재평가가 필수적이다. 본 증례에서는 제 3 대구치의 치근단 농양이 익돌하악간극(pterygomandibular space)으로 확산되어 발생한 내익돌근(medial pterygoid muscle)의 통증 및 개구제한에 관하여 경험하였기에 이를 보고하고자 한다.

• 대한정형외과학회지
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• 제54권2호
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• pp.120-126
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• 2019

목적: 내측 개방 근위 경골 절골술 후 통증 조절에서 관절 주위 다중 약물 국소 주사와 내전근관 차단술의 효과를 비교하고자 하였다. 대상 및 방법: 2016년 11월부터 2017년 3월까지 개방형 내측 근위 경골 절골술을 시행한 환자 60명을 대상으로 하여 후향적으로 분석하였다. 전 예에서 척추 마취를 시행하였으며, 수술 직전 선제 약물 투여 후 정맥내 자가 통증 조절 장치를 시행하였다. 30명의 환자(I군)는 관절 주위 다중 약물 국소 주사를 맞았고, 다른 30명의 환자(II군)는 내전근관 차단술을 시행 받았다. 두 그룹에 대해 수술 후 통증 수준, 추가적인 tramadol hydrochloride 주사의 빈도, 자가 통증 조절 장치 사용 총량 및 버튼을 누른 횟수 등을 비교하였다. 결과: 수술 후 2주째까지 시각통증점수(visual analogue scale)는 두 군 간에 유의한 차이를 보이지 않았다. 추가 tramadol hydrochloride 주사의 빈도는 두 군 간에 유의한 차이가 없었다. 자가 통증 조절 장치 버튼을 누르는 횟수와 평균 총 fentanyl 소비량에서도 그룹 간에 유의한 차이가 없었다. 결론: 내측 개방적 근위 경골 절골술을 시행한 환자의 급성기 통증 조절에 있어서 관절 주위 다중 약물 주입 및 내전근관 신경 차단술은 비슷한 효과를 가지는 것으로 생각된다.

• 치과방사선
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• 제27권1호
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• pp.25-41
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• 1997

The purpose of this study was to observe mandibular condyle shape and position in an asymptomatic population. In order to carry out this study, 142 temporomandibular joints in 71 adults(35 males, 36 females), who were asymptomatic for temporomandibular joint disorders and had no history of prosthodontic or orthodontic treatments, were selected, and radiographed using the Accurd-200 head holder(Denar Co., U.S.A) for transcranial radiograms and the Sectography(Denar Co., U.S.A) for lateral individualized corrected tomograms. Mandibular condyles were classified morphologically and evaluated in positional relationships with articular fossae and articular eminences at centric occlusion and 1 inch mouth opening. The obtained results were as follows; 1. In the classification of mandibular condyle shape, the convex type was more prevalent in transcranial radiograms and tomograms taken at medial, central, and lateral locations. 2. In the mandibular condyle position at centric occlusion, the mandibular condyles were placed posterior to the center of articular fossae in transcranial radiograms and anterior to the center of articular fossae in tomograms taken at medial, central, and lateral locations. 3. In the mandibular condyle position in right and left TMJs at centric occlusion, the mandibular condyles were placed bilateral asymmetric relationships to the articular fossae in transcranial radiograms and tomograms taken at medial, central, and lateral locations. 4. In the mandibular condyle position at 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminences in transcranial radiograms and tomograms taken at central location and posterior to the articular eminences in tomograms taken at medial and lateral locations.

• 대한기관식도과학회지
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• 제4권2호
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• pp.219-224
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• 1998

Bilateral vocal cord paralysis can result in severe airway compromise. Over the years a variety of arytenoidectomy procedures have bee described, and one or more of these have been the gold standard for many years. A widely accepted treatment is endoscopic laser total arytenoidectomy. However, vocal results are usually poor. Objective : To evaluate the effect of treatment of endoscopic laser medial partial arytenoidectorny for bilateral vocal cord paralysis Material and Methods : We performed endoscopic medial partial arytenoidceomy with $CO_2$laser for 3 patients with bilateral vocal cord paralysis. The $CO_2$laser is operated with a continuous 7-watt beam in superpulse mode. We compared degree of dyspnea and glottic area of pre-operation with those of post-operation for 3 patients. We analysed aerodynamic study pre-operatively and post-operatively for 1 patient. Results The symptom of dyspnea was improved markedly and the glottic area was widened from 34% to 50% compared with that of pre-operation. The voice quality was slightly decreased. Tracheotomy was not necessary for not-tracheotomized patient and decanulation was possible for tracheotomized patient post-operatively. Cunclusion： The endoscopic laser medial partial arytenoidectomy is a convient and effective method for opening the posterior glottic airway.

• 대한관절경학회:학술대회논문집
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• 대한관절경학회 제21차 추계 학술대회
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• pp.122-123
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• 2009

• 대한관절경학회:학술대회논문집
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• 대한관절경학회 제21차 추계 학술대회
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• pp.192-192
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• 2009

• 대한관절경학회지
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• 제3권2호
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• pp.150-154
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• 1999

공혈형 내측 활막추벽은 내측 활막추벽의 한 형태로 흔하지 않은 것으로 알려져 있으며 그 크기는 다양하여 직경 5mm에서 3-4cm 되는 것도 있다고 보고된다. 그 증상은 비특이적이나 다양한 내측 슬관절 증상을 유발하여 다른 슬관절 내장증의 원인들과 감별 진단이 요구된다. CT scan, MR imaging 등이 진단에 도움이 되지만 결정적인 진단은 관절경술에 의해 이루어지며 보존적 치료를 시행하고 이에 반응하지 않는 경우에 관절경적 절제술을 이용하여 치료를 시행하면 지속적이고 만족스러운 임상 호전을 얻을 수 있다고 보고된다. 본 정형외과 교실에서는 그 빈도가 흔하지 않은 양측 슬관절 공혈형 내측 활막추벽 증후군이 관찰되어 관절경적 절제술을 시행하고 술후 및 외래 추시시 즉각적이며 극적인 임상 호전을 보인 1례가 있어 문헌 고찰과 함께 임상 경험을 보고하는 바이다.

• 대한족부족관절학회지
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• 제27권2호
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• pp.71-74
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• 2023

A medial opening wedge supramalleolar osteotomy (SMO) introduced by Takakura et al. is a useful realignment procedure for patients with ankle joint arthritis and varus malalignment by shifting the weight-bearing axis laterally and redistributing the loads on the ankle joint. When pain persists after arthroscopic microfracture in patients with medial osteochondral lesion of the talus (OLT), redo arthroscopy, osteochondral autograft transplantation, autologous chondrocyte implantation, or matrix-induced chondrogenesis might be indicated. On the other hand, there is insufficient scientific evidence for realignment surgery through SMO, while the effect of realignment surgery has been studied consecutively for osteochondral lesions of the knee. Therefore, this paper reports a patient with medial OLT who underwent redo arthroscopy combined with SMO for persistent pain after primary arthroscopic microfracture.