• 제목/요약/키워드: Neck trauma

검색결과 252건 처리시간 0.024초

대퇴동맥에 발생한 의인성 거대 가성동맥류에 대한 치료 (Treatment of giant iatrogenic pseudoaneurysm of the femoral artery)

  • 강우성;박찬용
    • 한국산학기술학회논문지
    • /
    • 제20권3호
    • /
    • pp.423-428
    • /
    • 2019
  • 외상성 비장손상에 대한 비수술적 치료가 증가하면서 혈관조영술과 색전술의 역할이 증가하고 있다. 본 연구에서는 혈관조영술 후 발생한 대퇴동맥의 가성 동맥류를 트롬빈(thrombin) 주입과 코일(coil)을 이용한 색전술로써 효과적으로 치료한 증례를 보고하고자 한다. 55세 여자가 둔상성 외상으로 내원하였다. 전산화단층촬영에서 grade V 비장손상 소견을 보였으며, 조영제의 유출이 관찰되어 혈관조영술 및 색전술을 시행하였다. 내원 3일째 시행한 시행한 전산화단층촬영에서 비장의 재출혈 소견 보여 2차 색전술을 시행하였다. 내원 7일째 시행한 전산화단층 촬영에서 비장의 출혈 소견은 관찰되지 않았으나 우측 대퇴동맥 주위로 직경 $7.0cm{\times}4.0cm$ 크기의 가성동맥류가 발견되었다. 이 가성동맥류의 치료를 위해 초음파 유도하 트롬빈 주입을 시행하였으나 주입 후에도 혈류가 계속 유입되는 것이 컬러도플러초음파에서 관찰되었다. 이에 가성동맥류의 입구에 코일을 이용하여 색전술을 시행하였으며, 시술 후 혈관조영술에서 동맥류가 조영되지 않는 것을 확인하였다. 또한 추적 전산화단층촬영에서 동맥류가 조영되지 않고 크기도 감소하여 효과적으로 치료되었음을 확인하였다. 이후 환자는 특별한 합병증 없이 퇴원하였다. 저자들은 크기가 큰 대퇴동맥의 의인성 가성동맥류를 트롬빈과 코일을 이용하여 색전술을 시행함으로써 수술을 피하고 효과적으로 치료할 수 있었다.

Numerical simulation of the femur fracture under static loading

  • El Sallah, Zagane Mohammed;Smail, Benbarek;Abderahmane, Sahli;Bouiadjra, B. Bachir;Boualem, Serier
    • Structural Engineering and Mechanics
    • /
    • 제60권3호
    • /
    • pp.405-412
    • /
    • 2016
  • Bone is a living material with a complex hierarchical structure that gives it remarkable mechanical properties. Bone constantly undergoes mechanical. Its quality and resistance to fracture is constantly changing over time through the process of bone remodeling. Numerical modeling allows the study of the bone mechanical behavior and the prediction of different trauma caused by accidents without expose humans to real tests. The aim of this work is the modeling of the femur fracture under static solicitation to create a numerical model to simulate this element fracture. This modeling will contribute to improve the design of the indoor environment to be better safe for the passengers' transportation means. Results show that vertical loading leads to the femur neck fracture and horizontal loading leads to the fracture of the femur diaphysis. The isotropic consideration of the bone leads to bone fracture by crack propagation but the orthotropic consideration leads to the fragmentation of the bone.

양측성대마비의 10년간 경험 분석 (Bilateral Vocal Cord Paralysis : A 10-year Review of 42 Patients)

  • 김광문;김세헌;최홍식;최흥식;조정일;이준협
    • 대한후두음성언어의학회지
    • /
    • 제8권1호
    • /
    • pp.75-81
    • /
    • 1997
  • The clinical investigation was done in the 42 patients with bilateral vocal cord palsy who visited the otorhinolaryngologic department of the Yongdong Severance Hospital during the 10-year period between August 1986 to August 1996. On the sex and age distribution, the ratio of male to female patients was 2.8 : 1 and the age was evenly distributed and average was 46 years old. Of their chief complaints, dyspnea was the most common symptom. Among the position of the paralyzed vocal cords, paramedian position was most common. The most common causes of the bilateral vocal cord palsy was idiopathic Other causes include iatrogenic, prolonged intubation, head & neck trauma, brain tumor, Myasthenia Gravis, and mediastinitis. Our treament results were as follows. Recovery rate of idiopathic bilateral vocal cord palsy was 77.7% and recovery period after bilateral vocal cord palsy was shortened remarkedly after use with steroid. We performed laser arytenoidectomy in patients with irreversible idiopathic vocal cord palsy, neural injury, and cricoarytenoid joint fixation. Decannualtion was possible to be carried out in 86% of the patients and none of complication except for 1 case of aspiration developed. Thus we concluded that it was meaningful surgical treatment of bilateral vocal cord palsy.

  • PDF

외과적 절제술과 OK-432 경화요법을 병용한 임파관종의 치료: 증례보고 (TREATMENT OF LYMPHANGIOMA BY SURGICAL EXCISION AND SCLEROTHERAPY WITH OK-432 : A CASE REPORT)

  • 조주연;차두원;백상흠;이주덕
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제32권3호
    • /
    • pp.267-271
    • /
    • 2006
  • Lymphangiomas are benign tumors of the lymphatic system characterized by congenital lymphatic malformation such as anastomosis or obstruction of the lymphatic channels. They are most frequently diagnosed in children younger than 2 years, and the lymphangiomas in head and neck represent about 50-75% of all lymphangiomas. Spontaneous regression is rare, and rapid enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequence such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosing agents. Problems associated with surgical excision include the risk of scarring, damage to surrounding vital structure and the high risk of incomplete excision. The sclerosing agents previously used have numerous local and systemic side effects as their problems. We present a case of lymphangioma occured in tongue that was treated by surgical excision and sclerotherapy with OK-432.

자발성 두개내 저압환자에서의 경막외 혈액봉합술 (Epidural Blood Patch to Treat Spontaneous Intracranial Hypotension)

  • 이청;송준걸;박재홍;신진우;최윤;윤창섭
    • The Korean Journal of Pain
    • /
    • 제13권1호
    • /
    • pp.79-83
    • /
    • 2000
  • Background: Spontaneous intracranial hypotension is a syndrome characterized by postural headache without trauma, spinal anesthesia or other medical history. The purpose of this study is to analyze the effect of epidural blood patch in spontaneous intracranial hypotension. Methods: The spontaneous intracranial hypotension patients treated with epidural blood patch were analyzed on the symptoms, radiologic images and methods of epidural blood patch retrospectively by the medical records. Results: Patients had postural headache (15 patients) including nausea/vomiting (10 patients), tinnitus (2 patients), neck stiffness (13 patients), vertigo (3 patients) and occular pain (1 patient). Brain CT and MRI showed diffuse enhancement of the pachymeninges (9 patients) and radionuclide cisternography demonstrated direct evidence of leakage (11 patients). With epidural blood patch, the symptoms were promptly relieved in 11 patients. Conclusions: We concluded that epidural blood patch is a good treatment of method in spontaneous intracranial hypotension patients.

  • PDF

두개 파상풍의 치험례 (CEPHALIC TETANUS : A CASE REPORT)

  • 류승희;서일영;박홍주;오희균
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제30권4호
    • /
    • pp.345-348
    • /
    • 2004
  • Cephalic tetanus is a rare subtype of tetanus in which trismus is a charateristic symptom. The paralysis of one or more cranial nerves can occur. The 7th cranial nerve is most frequently involved. It account for 1 to 3% of the tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of tetanus cases progress to generalized tetanus. Generally, the symptoms of cephalic tetanus can include : facial pain, trismus, dysphagia, muscle twitching spasms of the face and jaw (risus sardonicus), neck stiffness and malaise. We present a case of cephalic tetanus who 54-year male patient had trismus and dysphagia. There was no history of trauma. As there was a delay in diagnosis of cephalic tetanus, respiratory disorder and intermittent general spasm occurred. The patient was treated by injection of antibiotics, muscle relaxant, and human anti-tetanus immunoglobulin. His symptoms were disappeared, and he was discharged ambulatory.

Rare Giant Upper Lip Epidermal Cyst in a Patient Wearing a Denture

  • Kim, Jong Chan;Hong, In Pyo
    • 대한두개안면성형외과학회지
    • /
    • 제17권4호
    • /
    • pp.222-224
    • /
    • 2016
  • Epidermal cysts are intradermal or subcutaneous cystic tumors that frequently occur in the face, scalp, neck, and body trunk. Acquired cases of epidermal cyst commonly occur as a result of various surgical operations, chronic irritation, or trauma, all of which may trigger the occurrence of the invagination of squamous epithelium. A 57-year-old man presented with a palpable mass $7cm{\times}2cm$ in size in the upper lip. The patient had a 3-year history of wearing a denture to restore missing bilateral maxillary central and lateral incisors, accompanied by inflammatory findings on the buccal mucosa due to chronic lip irritation. The resected oval-shaped cyst had a size of $5.5cm{\times}3.0cm{\times}2.5cm$, and it was an encapsulated mass with a well-defined margin. The histopathology was typical of epidermal cyst. This case of a rare giant upper lip epidermal cyst in a patient wearing a denture may be of interest to clinicians.

이물 육아종으로 오인된 심부 열상 이후 발생한 비정상적인 내측 족저 신경의 외상성 신경종: 증례 보고 (Unusual Presentation of Traumatic Neuroma of the Medial Plantar Nerve after Deep Laceration Mimicking a Foreign Body Granuloma: A Case Report)

  • 우승훈;김태우;배정연
    • 대한족부족관절학회지
    • /
    • 제21권4호
    • /
    • pp.174-178
    • /
    • 2017
  • Traumatic neuromas are rare benign tumors that are common after trauma or surgery and are usually accompanied by obvious symptoms of pain. Most reports show neuromas in the face, neck, and limbs, and the traumatic neuroma of the medial plantar nerve has rarely been reported. We encountered a traumatic neuroma of the medial plantar nerve after a deep laceration mimicking a foreign body granuloma. A small mass lesion was found around plantar aponeurosis with heterogeneous high signal intensity in the T2 fat suppression view and slightly enhanced intensity in the magnetic resonance imaging that suggested a foreign body granuloma. The lesion was diagnosed pathologically as a traumatic neuroma. A satisfactory clinical result was obtained after excision of the traumatic neuroma and burial of the proximal and distal stumps to the adjacent muscle at the secondary operation.

연축성 사경환자에 대한 도수 치료적 접근 - 사례연구 (Manual Therapy for Patient with Spasmodic Torticollis - Case Study)

  • 김동야;신의주;전재국
    • 대한정형도수물리치료학회지
    • /
    • 제19권1호
    • /
    • pp.79-83
    • /
    • 2013
  • Background: Spasmodic torticollis is a disorder that is described by sustained muscle contractions causing repetitive and twisting movements, and abnormal postures in a single body region. The purpose of this case is to describe the manual therapy for a patient with spasmodic torticollis. Methods: The patient was a 64 years old man with an 3 month history of left side laterocollis spasmodic torticollis. No known genetic history or trauma. Prior to intervention, his score on the Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 24, disability score was 20, pain score was 11. There is a noticeable distinction between left and right side cervical range of motion. The intervention consisted of manual therapy (MET, PNF) 3 times per week for the treatment during 4 weeks. Results: After intervention for 4weeks, his TWSTRS score and range of motion was improved quite a bit before therapeutic exercise. But symptoms are not improving sufficiently fast. Conclusions: Manual therapy is that MET and PNF is effective in improving for patient had spasmodic torticollis with laterocollis of neck.

  • PDF

하지에 발생한 피부 지방종성 신경섬유종의 치험례 (Cutaneous Lipomatous Neurofibroma on the Lower Leg : A Case Report)

  • 윤석호;정성노;권호
    • Archives of Plastic Surgery
    • /
    • 제36권4호
    • /
    • pp.500-502
    • /
    • 2009
  • Purpose: Cutaneous lipomatous neurofibroma is a rare variant of neurofibroma. Histologically, it includes adipose tissue. As far as we aware, only 11 cases of this variant were reported which was predominantly on head, neck and trunk, so we present a case of left pretibial area with literature review. Method: A 17 - year old female who showed a non - tender, protruding $4{\times}4{\times}2cm$ sized mass on the left pretibial area for several months. We totally excised the mass including skin and the subcutaneous fat layer. Results: Pathologic report showed cutaneous lipomatous neurofibroma which was well circumscribed and noncapsulated neoplasm present with focal fatty change. Adipose cells were entrapped in the whirls of spindle cells. There were no lipoblasts or atypical adipocytes. Conclusion: A cutaneous lipomatous neurofibroma on the lower extremity is very rare. In our patient, there were no trauma - related histopathologic changes. Therefore, focal fatty change can be a consequence of metaplasia from multipotential neural cells after migration.