• 제목/요약/키워드: Space resection

검색결과 115건 처리시간 0.025초

Expression of the CXCL12/SDF-1 Chemokine Receptor CXCR7 in Human Brain Tumours

  • Tang, Tian;Xia, Qing-Jie;Chen, Jian-Bin;Xi, Ming-Rong;Lei, Ding
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권10호
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    • pp.5281-5286
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    • 2012
  • Purpose: Receptor 7 (CXCR7) has recently been characterized as a novel receptor for CXCL12/SDF-1 (stromal cell derived factor-1). Given the demonstrated importance of CXCL12/SDF-1 in angiogenesis and tumour metastasis, we hypothesized that CXCR7 may also play a role in tumour pathogenesis. Located in the limited space of the intracranial cavity, any brain tumours can be inherently serious and life-threatening. However, the expression of CXCR7 in pituitary adenoma, neurilemmoma or hemangioblastoma remains to be elucidated. Therefore, we aimed to determine the potential contribution of CXCR7 in the development of brain tumours. Methods: In this study we examined and quantified the mRNA expression of CXCR7 in four different human brain tumours - 27 patients with neurilemmoma (8 patients), pituitary adenoma (7 patients), hemangioblastoma (6 patients), or meningioma (6 patients) undergoing surgical resection in the West China Hospital of Sichuan University. There were 15 females and 12 males aged from 28 to 70 years old. Total RNA was isolated and mRNA was measured by quantitative real-time RT-PCR. One-way analysis of variance (ANOVA) was performed using SPSS 11.0 statistical software to compare the mRNA levels of CXCR7 among four groups. Results: We found that CXCR7 mRNA was detected in all tumour samples. Quantitative results showed that the levels of CXCR7 mRNA in brain tissues from patients with neurilemmoma or meningioma were significantly higher than those with pituitary adenoma or hemangioblastoma. Conclusions: The results suggest that the CXCR7 may play a role in progression, metastasis and angiogenesis of brain tumours.

Surgical Treatment of Orbital Tumors at a Single Institution

  • Park, Hyun-Joon;Yang, Seung-Ho;Kim, Il-Sup;Sung, Jae-Hoon;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • 제44권3호
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    • pp.146-150
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    • 2008
  • Objective : The authors reviewed the experience of 19 patients with orbital tumors and summarize the clinical features, surgical treatment and outcomes. Methods : The authors searched the database for all patients who underwent surgery for the treatment of orbital tumors at a single institution between 1999 and 2007. Data from clinical notes, surgical reports, and radiological findings were obtained for the analysis. Results : Orbital tumors constituted a heterogenous array of histopathology. The presenting symptoms were exophthalmos (52.6%), visual disturbance (26.3%) and pain (21.1%). The surgical approaches used were transcranial in 17 patients. Tumors located in the intraconal or perioptic space were surgically excised using a frontoorbital approach (8 cases). while pterional (3 cases). orbital (2 cases) and combined approaches (6 cases) were used for tumors in other sites. Total resection of tumors was achieved in 12 of 19 patients. In 4 patients with glioma and lymphoma only diagnostic biopsy was done. Three patients experienced visual deterioration postoperatively. Two patients had temporary diplopia, and one patient had temporary ptosis. Conclusion : Surgical treatment could be the mainstay of therapy for the majority of symptomatic orbital tumors. Many orbital tumors can be treated safely via a transcranial approach. Frontoorbital approach allows the surgeon to reach both the intraorbital and intracranial structures. Knowledge of the microanatomy of the orbit and meticulous surgical skills are necessary to overcome the pitfalls of intraorbital surgery.

레이저 성문절제술 후의 음성수술 (Phonosurgery after Laser Cordectomy)

  • 소윤경;손영익
    • 대한후두음성언어의학회지
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    • 제19권1호
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    • pp.11-15
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    • 2008
  • Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

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구강재건을 위한 족배동맥피판의 해부학적 고찰 (Anatomical review of dorsalis pedis artery flap for the oral cavity reconstruction)

  • 김성민;강지영;어미영;명훈;이석근;이종호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권3호
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    • pp.184-194
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    • 2011
  • The dorsalis pedis artery (DPA) was renamed from the anterior tibialis artery after it passed under the extensor retinaculum, and DPA travels between the extensor hallucis longus and extensor digitorum longus muscle along the dorsum of the foot. After giving off the proximal and distal tarsal, arcuate and medial tarsal branches, DPA enters the proximal first intermetatarsal space via the first dorsal metatarsal artery (FDMA), which courses over the first dorsal interosseous muscle (FDIM). For detailed knowledge of the neurovascular anatomy of a dorsalis pedis artery flap (DPAF) as a routine reconstructive procedure after the resection of oral malignant tumors, the precise neurovascular anatomy of DPAF must be studied along the DPA courses as above. In this first review article in the Korean language, the anatomical basis of DPAF is summarized and discussed after a delicate investigation of more than 35 recent articles and atlas textbooks. Many advantages of DPAF, such as a consistent flap vascular anatomy, acceptable donor site morbidity, and the ability to perform simultaneous flap harvest using oral cancer ablation procedures, and additional important risks with the pitfalls of DPAF were emphasized. This article will be helpful, particularly for young doctors during the special curriculum periods for the Korean National Board of Specialists in the field of oral and maxillofacial surgery, plastic surgery, otolaryngology, orthopedic surgery, etc.

포메라이언견에서 발생한 동맥류성 골낭종 1례 (Aneurysmal Bone Cyst in a Pomeranian)

  • 신범준;이재연;김수현;박지영;이영원;조성환;김명철;정성목
    • 한국임상수의학회지
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    • 제27권1호
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    • pp.117-120
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    • 2010
  • A 5-years-old 3.7 kg intact female Pomeranian dog was presented with the history of swelling and pain in the distal part of the right forelimb. The swollen lesion was firm as bony material on palpation. On radiographic examination, there was a well-marginated, radiolucent, and expansile bone lesion in the distal metaphysis of the right ulna. Because of very narrow zone of transition, well-defined margins and absence of any periosteal reactivity, benign bone cyst was strongly suspected. The lesion was removed by en bloc resection and packed the space with $Gelfoam^{(R)}$ and aneurysmal bone cyst was finally diagnosed according to histopathological examination. Normal gait was showed on postoperative day 9 and there have been no pain and complication for 1 year since then.

동맥관개존증에 동반된 주폐동맥류의 수술치험 - 수술치험 1례 (Surgical Treatment of Main Pulmonary Artery Aneurysm with Patent Ductus Arteriosus -A Case Report-)

  • 김대식;이성주;권오우;김창회;채성수;오성철
    • Journal of Chest Surgery
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    • 제29권11호
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    • pp.1270-1275
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    • 1996
  • 폐동맥류는 매우 드문 질환으로 일반적으로 폐혈류량을 증가시키고 폐성 고혈압을 초래하는 선천성 심결손과 동반되어 발생되는 경우가 대부분이다. 폐동맥류의 예후는 매우 치명적 일 수 있는데, 그 이유는 동맥류의 파열에 대한 가능성과 대부분의 경우 심한 폐성 고혈압이 동반되어 있기 때문이다. 40세 여자 환자가 교통사고후 두통을 주소로 본원에 입원하였다. 내원 당시 이학적 검사상 좌흉골연을 따라 2번째와 3번째 늑간에서 연속성 심잡음이 청진되었고, 단순 흉부 X-선 사진상 좌측 폐문부의 석회화된 낭성 종괴가 우연히 발견되었다. 심도자검사상 좌-우 단락이 주폐동맥에서 관찰되었고, 폐동맥압이 증가되어 있었다. 그리고 폐동맥조영술상 주폐동맥에서 좌폐동맥 기시부로 연장되는 폐동맥류의 소견을 보였다. 저자들은 동맥관개존증을 동반한 주폐동맥류로 진단하고, 심폐우회하에 동맥류 절제, 동맥관 봉합 및 Dacron 이식편 치환술을 시행하였다. 술후 경과는 양호하였으며, 환자는 건강한 상태로 퇴원하였다.

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Utilizing a Novel Pituitary Retractor for Early Descent of the Diaphragma Sellae during Endoscopic Transsphenoidal Pituitary Surgery

  • Park, Jae-Sung;Chung, Dong-Sup;Yoon, Wan-Soo
    • Journal of Korean Neurosurgical Society
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    • 제65권1호
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    • pp.114-122
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    • 2022
  • Objective : Early descent of the diaphragm sellae (DS) during endoscopic endonasal transsphenoidal surgery (EETS) for pituitary macroadenoma surgery is occasionally a troublesome event by blocking the surgical field. Here we introduce an alternative technique with the new pituitary retractor and present our clinical experiences. Methods : We designed a simple and rigid pituitary retractor with the least space occupation in the nasal cavity to be compatible in EETS. The pituitary retractor was held by external holder system to support the herniated DS stably. We retrospectively reviewed a clinical 22 cases of pituitary macroadenomas underwent EETS using the pituitary retractor. Results : The pituitary retractor stably pushed up the herniated DS in all cases, and the surgeon proceeded the procedure with bimanual maneuver. The pituitary retractor was helpful to remove tumors around the medial cavernous sinus and behind the DS in 16 and seven cases, respectively. In four cases, the meticulous hemostasis was completed with the direct visualization by the DS elevation with this retractor. Gross total tumor resection was performed in 20/22 patients (91%). The impaired visual function and hypopituitarism were improved in 18/20 (90%) and 7/14 (50%) patients after surgery, respectively. There was no complication related with the pituitary retractor. Conclusion : During EETS for pituitary macroadenomas, the novel pituitary retractor reported in this study is a very useful technique when the herniated DS block the surgical field and bimanual maneuver. This pituitary retractor can help to result in the excellent surgical outcomes with minimal morbidity.

딥러닝을 이용한 CT 영상의 간과 종양 분할과 홀로그램 시각화 기법 연구 (A Study on the Liver and Tumor Segmentation and Hologram Visualization of CT Images Using Deep Learning)

  • 김대진;김영재;전영배;황태식;최석원;백정흠;김광기
    • 한국멀티미디어학회논문지
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    • 제25권5호
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    • pp.757-768
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    • 2022
  • In this paper, we proposed a system that visualizes a hologram device in 3D by utilizing the CT image segmentation function based on artificial intelligence deep learning. The input axial CT medical image is converted into Sagittal and Coronal, and the input image and the converted image are divided into 3D volumes using ResUNet, a deep learning model. In addition, the volume is created by segmenting the tumor region in the segmented liver image. Each result is integrated into one 3D volume, displayed in a medical image viewer, and converted into a video. When the converted video is transmitted to the hologram device and output from the device, a 3D image with a sense of space can be checked. As for the performance of the deep learning model, in Axial, the basic input image, DSC showed 95.0% performance in liver region segmentation and 67.5% in liver tumor region segmentation. If the system is applied to a real-world care environment, additional physical contact is not required, making it safer for patients to explain changes before and after surgery more easily. In addition, it will provide medical staff with information on liver and liver tumors necessary for treatment or surgery in a three-dimensional manner, and help patients manage them after surgery by comparing and observing the liver before and after liver resection.

The Safety and Efficacy of Cadaveric Allografts and Titanium Cage as a Fusion Substitutes in Pyogenic Osteomyelitis

  • Kim, Hyun-Woo;Ryu, Je-Il;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.348-356
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    • 2011
  • Objective : The safety and efficacy of various fusion substitutes in pyogenic osteomyelitis has not been investigated. We evaluated and compared the cadaveric allograft and titanium cages used to reconstruct, maintain alignment and achieve fusion in the management of pyogenic spinal infection. Methods : There were 33 patients with pyogenic osteomyelitis underwent fusion in this study. Fifteen of the 33 patients were operated on by fusion with allografts (cadaveric patella bones) and 18 of those were operated with titanium mesh cages filled with autologous cancellous iliac bone. After the affected disc and vertebral body resection with pus drainage, cadaveric allograft or titanium cages were inserted into the resected space. Posterior transpedicular screw fixation and rod compression in resected space, where cadaveric allograft or titanium cages were inserted, was performed to prevent the malposition in all patients except in 1 case. Recurrent infection was identified by serial erythrocyte sedimentation rate and cross reactive protein follow-up. Osseous union and recurred infection available at a minimum of 2 years following operation was identified. The amount of kyphosis correction and the subsidence were measured radiographically. Results : Spinal fusion was achieved in 29 of 33 patients. In the cadaveric allograft group, 93.3% of patient (14 of 15) showed the osseous union while 83.3% of patient (15 of 18) in the titanium cage group showed union. Subsidence was noted in 12 of the patients. Twelve patients (36.3%) showed unsettling amounts of subsidence postoperatively whereas 46.6% of patients in the cadaveric allograft group and 37.7% of patients in the titanium cage group showed similar subsidence, respectively. There were statistical difference in the fusion rate (p=0.397) and subsidence rate (p=0.276) between the two groups. There was significant statistical difference in the postoperative improvement of segmental kyphosis between the two groups (p=0.022), that is the improvement in sagittal alignment was greater in the titanium cage group than in the cadaveric allograft group. There was no case of recurred infection. Conclusion : The cadaveric allograft and titanium cages are effective and safe in restoring and maintaining sagittal plane alignment without increased incidence in infection recurrence in pyogenic osteomyelitis. The postoperative improvement of segmental kyphosis was better in the cage group.

슬관절 주위에 발생한 stage 3 거대세포종의 치료 (Treatment of stage 3 giant cell tumor around the knee)

  • 박원종;이승구;강용구;권오수;정양국
    • 대한골관절종양학회지
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    • 제9권1호
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    • pp.124-129
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    • 2003
  • 목적: 슬관절부에 발생한 제 3 기 거대세포종에 대해 수술적 치료 후 임상적, 방사선학적 결과를 알아보고자 후향적 분석을 시행하였다. 대상 및 방법: 1991년 3월부터 2000년 2월까지 슬관절부에 발생한 제 3기의 거대세포종으로 수술적 치료를 받은 21명의 환자를 대상으로 하였으며 추시기간은 최단 1년 최장 9년으로 평균 5.7년이었다. 수술방법으로11명에서 병소내 소파술 및 액화 질소 냉동 요법 후 시멘트 충진술을 시행하였고, 7명에서 병소내 소파술 시행 후 냉동 요법 없이 시멘트 충진술 또는 자가골 이식술을 시행하였다. 관절면의 파괴가 심했던 3명에서는 광범위 절제술 후 재건술을 시행하였다. 결과: 첫 수술 후 기능적 평가는 우수 및 양호가 13례, 보통이 4례, 실패가 4례였다. 국소 재발이나 감염으로 인해 실패로 판정되어 재수술을 시행한 4례에서 최종 추시시 기능적 결과는 우수 3례, 보통이 1례로, 전체적으로는 우수 및 양호가 16례, 보통이 5례였다. 소파술, 냉동요법 및 시멘트 충진술을 시행한 11명의 환자 중에는 1명(9.1%)에서 재발하였으며, 1명(9.1%)에서 슬관절의 퇴행성 변화를 보였으며, 냉동요법 없이 소파술 및 시멘트 충진술 또는 골이식을 받은 환자 7명중 2명(28.6%)에서 재발하였고, 1명에서(14.5%) 슬관절의 퇴행성 변화를 보였다. 결론: 철저한 소파술 및 냉동 보조요법은 슬관절부의 제 3기 거대 세포종 치료에 있어 유용한 방법이며, 광범위 절제술 및 재건술은 병변이 거대하고 관절면이 상당히 파괴되었거나, 수술 후 국소 재발로 인해 골파괴 및 관절 침범이 심한 경우에 시행하는 것이 바람직 할 것으로 사료된다.

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