• 제목/요약/키워드: Surgical success

검색결과 320건 처리시간 0.033초

이차공 심방 중격 결손의 폐쇄: 경피적 방법과 수술적 방법의 비교 (Closure of secundum atrial septal defect: comparison between percutaneous and surgical occlusion)

  • 김나연;권현정;최덕영;정미진;최창휴;김성호
    • Clinical and Experimental Pediatrics
    • /
    • 제50권5호
    • /
    • pp.469-475
    • /
    • 2007
  • 목 적 : 이차공 심방 중격 결손의 Amplatzer 기구를 이용한 경피적 폐쇄의 안정성, 효용성 및 임상 결과를 수술적 폐쇄법과 비교하기 위하여 본 연구를 시행하였다. 방 법 : 2000년 1월부터 2006년 6월까지 가천의과학대학교 길병원에서 이차공 심방 중격 결손으로 진단 받은 환자 115명을 대상으로 하였다. 그 중 70명에게 결손의 수술적 폐쇄술을 시행하였고, 45명의 환자에게 Amplatzer 기구를 이용한 경피적 폐쇄술을 시행하였다. 수술군과 시술군의 사망율, 합병증, 입원기간과 효용성을 조사하여 결과를 비교분석하였다. 결 과 : 전체 남녀 비는 1:2.4였다. 두 환자군에서 평균 연령과 결손크기는 유의한 차이가 없었다. 성공율은 시술군에서 97.8%, 수술군에서 100%였다. 전체 합병증은 수술군에서 시술군보다 많이 발생하였다(64.0 vs. 15.6%, P<0.05). 입원기간은 시술 군이 수술군보다 짧았다($4.2{\pm}1.2$ vs. $12.4{\pm}4.7days$, P<0.0001). 잔류단락은 시술군(8.9%)에서 수술군(4.3%)에 비해 더 많이 발생하였는데, 3개월후 추적 검사에서는 모두 소실되었다. 결 론 : 이차공 심방 중격 결손증의 Amplatzer 기구를 이용한 경피적 폐쇄는 수술을 대체할 수 있는 안전하고 효과적인 방법이다. 경험이 축적되고 기구가 발전하면서 경피적 폐쇄술의 적용 범위가 점차 확대되고 있다.

Photobiomodulation and Miescher's cheilitis granulomatosa: case report

  • Porrini, Massimo;Garagiola, Umberto;Rossi, Margherita;Bosotti, Moreno;Marino, Sonia;Gianni, Aldo Bruno;Runza, Letterio;Spadari, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제42권
    • /
    • pp.35.1-35.6
    • /
    • 2020
  • Background: Miescher's cheilitis granulomatosa (MCG) is a rare chronic inflammatory disease and is known as the monosymptomatic clinical form of Melkersson-Rosenthal syndrome (MRS). It is characterised by swelling of one or both lips and more frequently affects the upper lip. Histopathological findings show the presence of numerous inflammatory infiltrates and granuloma formations. Pharmacological treatments and surgery have provided results that are positive yet insufficiently stable in the long term. The clinical case described is of a 68-year-old female patient with a diagnosis of MCG of the upper lip. Case presentation: The patient was diagnosed and treated at the Oral Medicine and Oral Pathology outpatient clinic of Maxillofacial and Odontostomatology Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico. The patient was recommended localised treatments of photobiomodulation (PBM) using a diode laser with a 635 nm and 980 nm dual-wavelength (λ) approach, a 600-micron fibre, and a handpiece with a 1-cm-diameter lens at 300 mW. Three treatments a week were administered for four weeks for a total of 12 treatment sessions (T1-T12). After that, the patient had a long follow-up period of about 2 years. The therapeutic results were clear from the initial stages of treatment. There was an immediate, gradual, and consistent reduction in labial swelling. A reduction in the size of the lip by about 35% at T10-T12 was observed, returning the size and volume of the upper lip within the normal clinical range. The painful symptoms subsided after the seventh treatment (T7). The histopathological check at 3 months and the follow-up in particular confirmed the disease was in remission with satisfactorily stable treatment results. Moreover, the patient did not use any other treatments on the area from the early laser treatments through to the end of the follow-up period. Conclusions: Our experience describes a clinical case of MCG treated with PBM and effectively resolved with a reduction of the lip swelling. The real success of the treatment emerged over time, showing that the tissue healing was stable. In absence of any collateral phenomena, this confirms the effective and documented therapeutic potential of PBM for chronic inflammatory infiltrates.

Head and neck reconstruction using free flaps: a 30-year medical record review

  • Suh, Joong Min;Chung, Chul Hoon;Chang, Yong Joon
    • 대한두개안면성형외과학회지
    • /
    • 제22권1호
    • /
    • pp.38-44
    • /
    • 2021
  • Background: The free flap surgical method is useful for the reconstruction of head and neck defects. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 30 years. Methods: Between 1989 and 2018, a total of 866 free flap procedures were performed on 859 patients with head and neck defects, including 7 double free flaps. The causes of vascular crisis and salvage rate were analyzed, and the total flap survival rate calculated among these patients. Additionally, the survival and complication rates for each flap type were compared. Results: The 866 cases included 557 radial forearm flaps, 200 anterolateral thigh flaps, 39 fibular osteocutaneous flaps, and 70 of various other flaps. The incidence of the vascular crisis was 5.1%; its most common cause was venous thrombosis (52.3%). Salvage surgery was successful in 52.3% of patients, and the total flap survival rate was 97.6%. The success rate of the radial forearm flap was higher than of the anterolateral flap (p< 0.01), and the primary sites of malignancy were the tongue, tonsils, and hypopharynx, respectively. Conclusion: The free flap technique is the most reliable method for head and neck reconstruction; however, the radial forearm free flap showed the highest success rate (98.9%). In patients with malignancy, flap failure was more common in the anterolateral thigh (5.5%) and fibular (5.1%) flaps.

Microscopic versus Endoscopic Inlay Butterfly Cartilage Tympanoplasty

  • Lee, Se A;Kang, Hyun Tag;Lee, Yun Ji;Kim, Bo Gyung;Lee, Jong Dae
    • Journal of Audiology & Otology
    • /
    • 제23권3호
    • /
    • pp.140-144
    • /
    • 2019
  • Background and Objectives: Inlay butterfly cartilage tympanoplasty makes the graft easy, and reduces operating time. The present study aimed to investigate the outcomes of microscopic versus endoscopic inlay butterfly cartilage tympanoplasty. Subjects and Methods: In this retrospective study, the outcomes of 63 patients who underwent inlay butterfly cartilage tympanoplasty with small to medium chronic tympanic membrane perforation were evaluated. Twenty-four patients underwent conventional microscopic tympanoplasty and 39 underwent endoscopic tympanoplasty. The outcomes were analyzed in terms of the hearing gain and graft success rate. Results: The surgical success rate was 95.8% in the patients who underwent conventional microscopic tympanoplasty and 92.3% in those who underwent endoscopic tympanoplasty. In both groups of patients, the postoperative air-bone gap (ABG) was significantly lower than the preoperative ABG. There were no significant differences between the preoperative and postoperative ABG values in either group. Conclusions: Endoscopic inlay tympanoplasty using the butterfly cartilage technique appears to be an effective alternative to microscopic tympanoplasty and results in excellent hearing.

Microscopic versus Endoscopic Inlay Butterfly Cartilage Tympanoplasty

  • Lee, Se A;Kang, Hyun Tag;Lee, Yun Ji;Kim, Bo Gyung;Lee, Jong Dae
    • 대한청각학회지
    • /
    • 제23권3호
    • /
    • pp.140-144
    • /
    • 2019
  • Background and Objectives: Inlay butterfly cartilage tympanoplasty makes the graft easy, and reduces operating time. The present study aimed to investigate the outcomes of microscopic versus endoscopic inlay butterfly cartilage tympanoplasty. Subjects and Methods: In this retrospective study, the outcomes of 63 patients who underwent inlay butterfly cartilage tympanoplasty with small to medium chronic tympanic membrane perforation were evaluated. Twenty-four patients underwent conventional microscopic tympanoplasty and 39 underwent endoscopic tympanoplasty. The outcomes were analyzed in terms of the hearing gain and graft success rate. Results: The surgical success rate was 95.8% in the patients who underwent conventional microscopic tympanoplasty and 92.3% in those who underwent endoscopic tympanoplasty. In both groups of patients, the postoperative air-bone gap (ABG) was significantly lower than the preoperative ABG. There were no significant differences between the preoperative and postoperative ABG values in either group. Conclusions: Endoscopic inlay tympanoplasty using the butterfly cartilage technique appears to be an effective alternative to microscopic tympanoplasty and results in excellent hearing.

무수정체안과 인공수정체안에 대한 Mitomycin C를 이용한 일차 섬유주절제술의 효과 (Trabeculectomy Using Mitomycin C in Aphakic and Pseudophakic Eyes)

  • 손준혁;차순철
    • Journal of Yeungnam Medical Science
    • /
    • 제24권2호
    • /
    • pp.232-242
    • /
    • 2007
  • 녹내장으로 수술적 치료가 필요한 무수정체안과 인공수정체안 환자들에게서 Mitomycin C(MMC)를 사용한 섬유주절제술을 시행하고 유용성을 알아보고자 하였다. 1994년 5월부터 2002년 2월까지 영남대학교 의과대학 부속병원 안과에서 무수정체안과 인공수정체안에 녹내장 치료로 MMC의 국소접촉법을 이용한 섬유주 절제술을 시행하고 6개월 이상 추적관찰 가능 하였던 45명 51안을 대상으로 녹내장의 유형, 기왕의 안수술, 백내장수술의 종류, 수정체 후낭의 상태, 인공수정체 유뮤에 따른 성공률과 수술 실패의 위험인자 및 합병증 등을 의무기록을 바탕으로 후향적으로 조사하였다. 수술 성공 여부의 기준은 술 후 안압하강제 사용에 관계없이 술 후 최종 안압이 21 mmHg이하이며 시력상실이 없는 경우를 성공으로 판정하였다. MMC를 사용한 일차 섬유주절제술 후 평균 관찰 기간은 27.7개월이었으며 수술 성공률은 70.6%(36안/51안)이었다. Kaplan-Meier 생존분석을 이용한 누적 성공률은 3개월에 98.0%, 6개월에 94.1%, 12개월에 91.9%, 24개월에 83.4%, 36개월에 75.5%로서 보고된 고식적 섬유주 절제술의 성공률보다 높았다. 술 전 안압이 30mmHg 미만으로 낮았던 환자들과 이전 백내장 수술을 제외한 안 수술의 기왕력이 없었던 환자들에게 의미있게 수술 성공률이 높은 것으로 조사되었다. 술 후 합병증으로는 전방출혈과 맥락막박리가 각 4안에서, 저안압이 3안, 그리고 얕은 전방과 안내염이 각 1안에서 발생하였다. 결론적으로 무수정체안과 인공수정체안의 녹내장에서 MMC 섬유주절제술은 기존 보고된 방수유출장치술의 수술 성공률에 비해 낮지 않으면서도 합병증이 적다는 점에서 방수유출장치삽입술에 앞서 우선적으로 선택할 수 있는 유용한 수술 방법이라고 생각된다.

  • PDF

전방십자인대의 최적 재건을 위한 등장성 해석 (Analysis of Isometry of the Anterior Cruciate Ligament for Optimal Ligament Reconstruction)

  • 박정홍;서정탁;문병영;손권
    • 대한기계학회논문집A
    • /
    • 제30권4호
    • /
    • pp.457-464
    • /
    • 2006
  • The anterior cruciate ligament (ACL) is liable to a major injury that often results in a functional impairment requiring surgical reconstruction. The success of reconstruction depends on such factors as attachment positions, initial tension of ligament and surgical methods of fixation. The purpose of this study is to find isometric positions of the substitute during flexion/extension. The distance between selected attachments on the femur and tibia was computed from a set of measurements using a 6 degree-of-freedom magnetic sensor system. A three-dimensional knee model was constructed from CT images and was used to simulate length change during knee flexion/extension. This model was scaled for each subject. Twenty seven points on the tibia model and forty two points on the femur model were selected to calculate length change. This study determined the maximum and minimum distances to the tibial attachment during flexion/extension. The results showed that minimum length changes were $1.9{\sim}5.8mm$ (average $3.6{\pm}1.4mm$). The most isometric region was both the posterosuperior and anterior-diagonal areas from the over-the-top. The proposed method can be utilized and applied to an optimal reconstruction of ACL deficient knees.

저 악성도 연골 육종에서 발생한 미분화 연골육종 - 1례 보고 - (Dedifferentiated Chondrosarcoma from Low Grade Chondrosarcoma)

  • 박종훈;고한상;이수용
    • 대한골관절종양학회지
    • /
    • 제11권2호
    • /
    • pp.213-218
    • /
    • 2005
  • 미분화 연골육종은 연골육종 중 가장 악성도가 높은 종양으로서, 연골육종의 약 10%에서 발생되는 것으로 알려져 있다. 미분화 연골 육종에 의해 발생된 악성종양은 방사선 및 화학요법에 반응을 하지 않아 광범위 종양 절제술만이 근치적 치료법이다. 본 연구는 근위 대퇴골에 발생한 저악성도 연골육종을 보존적으로 수술하고 추시 관찰 중, 골육종으로 미분화한 연골육종 1례를 보고하고자 한다.

  • PDF

수정란이식의 산업화 방안 (Industrial Application of Embryo Transfer in Korea)

  • 정길생
    • 한국가축번식학회지
    • /
    • 제7권2호
    • /
    • pp.41-52
    • /
    • 1983
  • Animal in dustry in Korea urgently needs the domestic introduction and the industrial a, pp.ication of embryo transfer technique. Namely, this technique can be utilized effectively, as means of the improvement of livestocks, as means of the increase of meat production, as means of substitute for the livestock import, and dissemination of new breed. However, as this technique avaliable in our country is remaining initial stage, we can not make use of the technique industrially unless we make much improvement as follows; induction of superovulation, non-surgical recovery of embryos, synchronization between the estrus such cycles of donor and recipient, non-surgical transfer of embryos, etc. Simultaneously, the basic studies such as harvesting oocytes from ovary, in vitro culture of oocytes, in vitro capacitation of spermatozoa, cloning by culture of blastomeres and transfer of nuclei, sexing embryo, etc. should not be neglected in order to make the technique of embryo transfer more simple and convenient. For the success of these studies, universities, national and public institutes, large scale cattle farms, and small scale cattle farms should cooperate each other. For instance, universities undertake basic researches, and the national and public institutes a, pp.y the results of the researches to animal industry along with cooperation by large scale cattle farms. By the help of the cooperative organizations, the technique relevant to our environment and farm condition may be able to be finalized, and to be a, pp.ied to samll scale cattle farm. Consequently, being served to stimulate animal productivity, this technique can be contributed to the development of livestock industry in Korea.

  • PDF

심실중격결손과 동반한 다중판막 감염성 심내막염의 수술적 치료 (Surgical Treatment of Multivalvular Endocarditis with Ventricular Septal Defect)

  • 김선희;제형곤;이상권;김상필
    • Journal of Chest Surgery
    • /
    • 제43권4호
    • /
    • pp.417-420
    • /
    • 2010
  • 다중판막을 침범한 감염성 심내막염은 단일 심내막염에 비해 사망률이 높고 합병증의 발생이 빈번하여 일반적으로 조기수술이 권장된다. 저자들은 고열을 주소로 입원한 46세 환자에서 심초음파 검사로 폐동맥판막, 삼첨판막, 승모판막을 침범한 급성 심내막염 및 심실중격결손을 진단하였고, 항생제 치료에도 감염증이 악화되어 응급수술을 시행하였다. 비교적 드문 증례를 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.