• 제목/요약/키워드: Tree Surgery

검색결과 138건 처리시간 0.03초

Fin type 임플랜트 고정체의 유한요소법적 분석 (FINITE ELEMENT ANALYSIS OF FIN-TYPE IMPLANT FIXTURES)

  • 김수관;전창길;황갑운;김병옥
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권1호
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    • pp.14-25
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    • 2003
  • The purpose of this study was to analyze the stress pattern in different bone densities surrounding fin-type implant fixtures under the vertical and inclined loads ($30^{\circ}) of 200N. Von-Mises stress, the pricipal stress, and the displacement on the implant fixtures under the loads were calculated by using the finite element method. Four different types of bicon implant fixture were used for this study. The geometries of implant fixtures to develop the model were used by a sales brochure and profile project. Three-dimensional finite element model of the mandible was developed with 6.0 mm implant in diameter wurrounded by approximately 2.5 mm of bone. Bone densities were classified according to the elastic modulus of the tree. The finite element program MSC PATRAN (MSC, Software Corp., USA) were used for analysis of stress distribution. The value of the Von-Mises stress, the pricipal stress, and the displacement on the implant fixtures under the vertical and inclined loads were decreased when the diameter of implant fixture was increased, and increased when the elastic modulus was decreased. The stress on implant fixture under the vertical and inclined loads was distributed through the length of implant fixtures in D3 and D4. The distribution of stress was influenced by the direction of loads. In the wide diameter of implants, the stress was developed at outer surface of bone. In conclusion, this study suggest that stress developing on the peri-implant tissues might be influenced by the dimension of implant, elastic modulus of bone, and direction of loads.

터널화가 시행된 대구치의 장기적인 임상적 방사선학적 평가 (Long Term Clinical and Radiographical Evaluation of Tunneled Molars)

  • 백영란;박진우;서조영;진명욱;이재목
    • Journal of Periodontal and Implant Science
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    • 제38권3호
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    • pp.521-528
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    • 2008
  • Purpose: Tunneling is a periodontal surgical procedure that creates access for patient cleansing and maintenance within the furcal area of a molar tooth with severe furcation involvement. Up to date, there are few studies about a long term clinical and radiographic stability of tunneling. The purpose of this retrospective study is to evaluate the long term prognosis after tunnel preparation of molars with through and through furcation. Material and Methods: 25 teeth of 23 patients aged 36 to 70 (mean age 51.7) were treated surgically with tunnel preparation. These cases were followed for 2 to 13 years (mean 6.5years) after surgery. Patients were recalled for an evaluation which was based on a questionnaire, a clinical examination, and radiographic analysis. Clinical assessment included plaque index, caries registration, probing pocket depth, bleeding on probing, tooth mobility. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Result: 3 teeth(12%) had been extracted and 1 tooth(4%) hemisected. Root caries was detected in 3 teeth(12%). Thus 72% of the teeth were still caries tree and in function. Clinical parameters including PI, PD, BOP, mobility showed somewhat favourable results. Radiographic furcal bone loss showed no statistically significant difference compared to interproximal crestal bone loss ($3.59{\pm}1.69%$ vs $3.42{\pm}2.95%$) when root length was used as reference. There was no correlation between root trunk length and furcal bone loss. Conclusion: Over 2 years after tunneling procedure, teeth showed a clinically and radiographically stable condition, despite of slight root caries and alveolar bone loss within clinically acceptable range. The tunnel procedure may be considered as a viable periodontal treatment option for molar teeth with severe furcation involvement in individuals following a regular maintenance program.

Indications and findings of flexible bronchoscopy in trauma field in Korea: a case series

  • Dongsub Noh
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.206-209
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    • 2023
  • Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

Histopathological Study and Expression of Beta-Catenin in Congenital Choledochal Cyst in a Tertiary Care Pediatric Referral Center in South India

  • Rashmi Tresa Philpose;Abdul Aleem Mohammed;Ashrith Reddy Gowni
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권1호
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    • pp.62-70
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    • 2024
  • Purpose: Choledochal cysts are congenital anomalies that occur as localized cystic or fusiform dilatations of the biliary tree. Reflux and stasis of pancreatic enzymes in the biliary duct may relate to the development of intestinal metaplasia which might be an important factor related to the carcinogenesis of choledochal cyst, thus the expression of beta-catenin in the metaplastic epithelium might be associated with malignant transformation of choledochal cyst epithelium. Methods: This study was conducted at a tertiary care pediatric center between October 2014 and March 2017. Forty patients were evaluated for epithelial lining, mural ulceration, fibrosis, inflammation, and metaplasia. Results: Out of 40, 12 cases (30.0%) were the infantile age group and 28 cases (70.0%) were in the classic pediatric group. Ulceration was classified as grade 0 (14 cases, 35.0%), grade 1 (17 cases, 42.5%), or grade 2 (nine cases, 22.5%). Inflammation was classified as grade 0 (2 cases, 5.0%), grade 1 (26 cases, 65.0%), or grade 2 (12 cases, 30.0%). Fibrosis was classified as grade 0 (five cases, 12.5%), grade 1 (11 cases, 27.5%), grade 2 (17 cases, 42.5%), or grade 3 (seven cases, 17.5%). Metaplasia was noted in five (12.5%) out of 40 cases. All choledochal cysts with metaplasia showed beta-catenin nuclear positivity on immunohistochemistry and were followed up. Conclusion: This study emphasizes the importance of detailed histopathological examination and documentation of metaplastic changes. Metaplasia was associated with beta-catenin nuclear positivity. These findings suggest a potential role for beta-catenin as a marker of metaplastic changes in choledochal cysts.

악성 골종양 세포주들에 대한 Taxol의 세포독성 (Cytotoxic Effect of Taxol on Malignant Bone Tumor Cell Lines)

  • 신덕섭;김세동;김건호;이종형;김성용;김정희
    • 대한골관절종양학회지
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    • 제4권1호
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    • pp.13-21
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    • 1998
  • Taxol이 악성 골종양 세포에 어느 정도의 세포독성이 있는지를 평가하기 위해 한국세포주 은행에서 분양 받은 G-292, SaOS-2 및 HT-1080의 3가지 악성 골종양 세포들을 대상으로 기존의 항암제인 methotrexate, adriamycin, ifosfamide, cisplatinum과 함께 각각 투여하여 MTT분석법으로 정량 및 비교 분석하였으며, adriamycin과 taxol을 병용 투여하여 항암제의 상호작용을 isobologram 분석법으로 조사하여 다음과 같은 결과를 얻었다. 1. Taxol의 악성 골종양 세포 주들에 대한 $IC_{50}$는 G-292에서는 $2.7{\times}10^{-2}{\mu}g/ml$, $SaOS^{-2}$에서는 $1.0{\times}10^{-2}{\mu}g/ml$, $HT{\times}1080$에서는 $1.1{\times}10^{-3}{\mu}g/ml$이었다. 2. Taxol은 악성 골종양 세포주들에 대해 기존의 항암제들 보다 강한 세포독성을 보였으며, 기존 항암제의 세포 독성의 강도는 adriamycin이 제일 높은 역가를 보였으며 그 외 methotrexate, cisplatinum, ifosfamide순이었다. 3. Taxol과 adriamycin을 병용 투여하여 상호작용을 관찰한 결과 G-292와 SaOS-2 세포 주에서 상승효과가 관찰되었으며, HT-1080에서는 상승효과가 관찰되지 않았다.

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진안 평지리 이팝나무군(천연기념물 제214호)의 생육진단 및 관리방안 (A Study on the Growth Diagnosis and Management Prescription for Population of Retusa Fringe Trees in Pyeongji-ri, Jinan(Natural Monument No. 214))

  • 노재현;오현경;한상엽;최영현;손희경
    • 한국전통조경학회지
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    • 제36권3호
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    • pp.115-127
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    • 2018
  • 천연기념물 제214호 진안 평지리 이팝나무군의 고사(枯死) 및 쇠약(衰弱) 요인의 명확한 진단(診斷)과 처방(處方)을 통한 천연기념물로서의 가치 존속(存續) 방안을 강구하고자 시도된 본 연구의 결과는 다음과 같다. 첫째, 1968년 13그루의 천연기념물 지정 이후, 1973년을 시작으로 근년까지 계속적으로 고사가 진행되어 현재는 3주만 생존하고 있다. 특히 2010년 이후 마령초등학교 담장 후퇴 등 정비과정에서 복토된 토양의 일부 제거에도 불구하고, 계속적으로 고사가 이루어진 것으로 확인된다. 둘째, 지정목 중 1 3번 생존목 또한 고사된 가지가 많고, 잎이 왜소하며, 엽량이 적었다. 1번목은 수세가 '극히 불량'하고 다량의 가지가 이미 고사하였으며, 금년에는 단지 2개 가지에서만 개화가 이루어졌으며 엽량 또한 현저히 적은 상태이다. 2번목 또한 '불량'상태로 잎이 작고 엽밀도도 낮으며 수형의 변형이 이루어지는 등 수세가 쇠약한 상태이다. 현존하는 가장 큰 1번목은 논토양으로 추정되는 점질토가 복토되어 있어 우려를 더하고 있다. 셋째, 평지리 이팝나무군의 토성 분석결과, '미사질양토[微砂質壤土, Silt loam(SiL)]'로 밝혀짐에 따라 미사(Silt)의 성분비가 높음을 알 수 있다. 또한 1번목 북측의 토양산도는 pH 6.6으로 다른 부위의 흙과는 편차가 컸는데 이는 원지반 토양이 아닌 외부에서 반입된 토양으로 복토되었음에 기인한 것으로 판단된다. 더불어 유기물함량은 적정범위보다 높게 나타났는데 이는 보호관리를 위한 시비가 계속적으로 이루어진 결과가 반영된 것이라고 판단된다. 넷째, 진안 평지리 이팝나무군의 고사 및 생육 불량의 근본적 원인으로는 복토(覆土)로 인한 심각한 생리저하의 만성적 증후군으로 판단된다. 이는 신규로 식재된 후계목 또한 일부 고사된 것에서도 그 원인을 찾을 수 있다. 다섯째, 1차적으로 기존 고사의 원인으로 추정되는 복토 부분에 대한 점진적 제거가 시급하다. 무엇보다도 근계부에 복토된 점질토양의 제거를 건의한다. 복토부를 제거한 후 굵은 모래로 치환하고 뿌리의 호흡 개선을 위해 유공관을 설치한다. 그리고 고사한 4번 고사목과 5 6번의 고사흔적인 밑둥은 제근하고, 하층식생은 예초한다. 생존목은 상부 고사지를 제거, 수피 이탈부는 외과수술을 시행하는 한편 생장점 아래에서 전정하여 맹아의 발생을 유도해야 할 것이다. 여섯째, 지하부 뿌리를 확인하여 부패근 절단 및 토양호흡 개선방안을 마련한다. 근계 전반에 대한 추적 굴취 등으로 썩은 뿌리부를 단근하여 새 뿌리의 발생을 유도한다. 일곱째, 이후 잡초 발생과 답압 억제 그리고 토양 보습효과 유지를 위한 멀칭을 시도한다. 또한 지속적 영양공급을 위한 무기양료 엽면시비 및 영양제 나무주사, 무기양료의 토양관주를 고려한다. 향후 모니터링과 예찰방안을 마련하여 계속적으로 변화상을 체크해야 할 것이다.

이하선암의 술후 방사선치료시 방사선치료 방법에 따른 치료 실패 양상 분석 (Patterns of Failure According to Radiation Treatment Technique in the Parotid Gland Cancer)

  • 이상욱;이창걸;금기창;박정수;최은창;신현수;추성실;이석;조광환;서창옥;김귀언
    • 대한두경부종양학회지
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    • 제16권2호
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    • pp.167-171
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    • 2000
  • Objectives: To compare the outcomes of treatment with a focus on the effectiveness of the two primary techniques of radiation used for treating parotid gland malignancies. Materials and Methods: A retrospective analysis of 70 patients with parotid gland cancer treated between 1981-1997. Radiation was delivered through an ipsilateral field of high energy electron and photon in 37 patients(52.9%). Two wedge paired photon was used to treat in 33 patients(47.1%). The median dose was 60 Gy, typically delivered at 1.8-2.0Gy per fraction. The median follow-up times for surviving patients was 60 months. Results: The overall and disease free 5 year survival rates were 71.6% and 69.5%, respectively. Wedge paired photon and photon-electron treatment disease tree 5 year survival rates were 61.1% and 80.5%, respectively. Overall local failure rate was 18.6%. Local failure rate of wedge paired photon technique was higher than that of mixed beam technique. Late complication rate was 37.1%, but most of them were mild grade. Conclusion: Techniques of radiation were associated with local control. The technique of using an ipsilateral field encompassing the parotid bed and treated with high energy electrons often mixed photons was effective with minimal severe late toxicity. To irradiate deep sited tumors, we consider 3-D conformal treatment plan for well encompassing the target volume.

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Calpain-10 SNP43 and SNP19 Polymorphisms and Colorectal Cancer: a Matched Case-control Study

  • Hu, Xiao-Qin;Yuan, Ping;Luan, Rong-Sheng;Li, Xiao-Ling;Liu, Wen-Hui;Feng, Fei;Yan, Jin;Yang, Yan-Fang
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6673-6680
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    • 2013
  • Objective: Insulin resistance (IR) is an established risk factor for colorectal cancer (CRC). Given that CRC and IR physiologically overlap and the calpain-10 gene (CAPN10) is a candidate for IR, we explored the association between CAPN10 and CRC risk. Methods: Blood samples of 400 case-control pairs were genotyped, and the lifestyle and dietary habits of these pairs were recorded and collected. Unconditional logistic regression (LR) was used to assess the effects of CAPN10 SNP43 and SNP19, and environmental factors. Both generalized multifactor dimensionality reduction (GMDR) and the classification and regression tree (CART) were used to test gene-environment interactions for CRC risk. Results: The GA+AA genotype of SNP43 and the Del/Ins+Ins/Ins genotype of SNP19 were marginally related to CRC risk (GA+AA: OR = 1.35, 95% CI = 0.92-1.99; Del/Ins+Ins/Ins: OR = 1.31, 95% CI = 0.84-2.04). Notably, a high-order interaction was consistently identified by GMDR and CART analyses. In GMDR, the four-factor interaction model of SNP43, SNP19, red meat consumption, and smoked meat consumption was the best model, with a maximum cross-validation consistency of 10/10 and testing balance accuracy of 0.61 (P < 0.01). In LR, subjects with high red and smoked meat consumption and two risk genotypes had a 6.17-fold CRC risk (95% CI = 2.44-15.6) relative to that of subjects with low red and smoked meat consumption and null risk genotypes. In CART, individuals with high smoked and red meat consumption, SNP19 Del/Ins+Ins/Ins, and SNP43 GA+AA had higher CRC risk (OR = 4.56, 95%CI = 1.94-10.75) than those with low smoked and red meat consumption. Conclusions: Though the single loci of CAPN10 SNP43 and SNP19 are not enough to significantly increase the CRC susceptibility, the combination of SNP43, SNP19, red meat consumption, and smoked meat consumption is associated with elevated risk.

주타액선종양 104례에 대한 분석 (A Clinical Analysis of Major Salivary Gland Tumors-104 Cases)

  • 김명상;김영호;홍정표;최은창;김광문;홍원표
    • 대한두경부종양학회지
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    • 제14권1호
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    • pp.40-45
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    • 1998
  • Backgroud and Objectives: Major salivary gland tumor is a rare disease with a largely unknown origin. And also corresponding to the diversity of histopathologic characteristics is an equally wide distribution of clinical behavior that makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guidline of management. Materials and Methods : We studied clinical manifestations and treatment results of 104 patients who were diagnosed as major salivary gland tumors. Tumor site, patient age and sex of the patients were analysed. Histopathologic diagnosis, treatment modality, lymph nodes metastasis, recurrence rate and 5-year survival rate were studied on malignant tumors. Results: 1) 48 patients were male and 56 patients were female. 2) Benign tumors were 79 cases. They consisted of 57 cases(72%) of parotid tumor, 22 cases(27%) of submandibular tumor. And pleomorphic adenoma was the most common benign tumor. 3) Malignant tumors were 25 cases and were consisted of 19 cases(76%) of parotid tumor, 4 cases(l6%) of submandibular tumor and 2 cases(8%) of sublingual gland tumor with high-grade mucoepidermoid carcinoma as the most common cause. 4) In the malignant tumors, the number of stage I, II tumors was 14 and that of stage III, IV tumors was 11. Neck node metastasis was noted in 8 cases. 5) 8 cases of malignant tumor were died and all of them had high-grade malignancy. And they were dead before 17 months from the time of diagnosis. 6) Mean survival duration in the malignant salivary gland tumor was 56 months. 7) High-grade malignancy had a 5-year survival rate of 57.9%. A 5-year survival rate of TI, T2 patients was 92.9% and that of T3, T4 patients was 36.4%. That of patients who had neck node metastasis was 37.5% and that of those who had tree neck was 82.4%. Conclusion: The results of this study suggest that the survival rate is dependent on the tumor size, lymph node matastasis and histologic grade. And also the early diagnosis and radical surgery result in the increased survival rate and are effective for prevention of the tumor recurrance.

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임파구형 간질성 폐렴 1예 (A Case of Lymphocytic Interstitial Pneumonitis)

  • 정희진;조은래;심재정;인광호;유세화;강경호;원남희;최영호
    • Tuberculosis and Respiratory Diseases
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    • 제40권5호
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    • pp.602-609
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    • 1993
  • 저자들은 경부 동통과 촉진시 공기 마찰음, 기침을 주소로 내원한 종격동 기흉환자를, 흉부 컴퓨터 촬영 및 개흉 폐조직 검사로 임파구형 간질성 폐렴으로 진단하였다. 또한 동반된 자가면역 질환이나 면역 부전 상태의 유무를 알기 위하여 다양한 혈청학적 검사를 시행하였으며, 그 결과 원발성으로 발생한 임파구형 간질성 폐렴임을 알수 있었으며, 치료적 목적으로 스테로이드 투여를 시도하였으나 임상 양상에 큰 호전을 보이지 않아 세포 독성 약제등의 투여를 고려 중이다. 그러나, 현재까지 확립된 병인 기전이나 치료 방법등에 대한 정설이 없으며 최근 AIDS 환자들에게서의 발생이 많이 보고됨에 따라 이 질환의 원인 및 경과를 예측할 수 있는 지표등에 대한 연구가 계속 되어야 할 것으로 생각된다.

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