• 제목/요약/키워드: dissection

검색결과 1,488건 처리시간 0.034초

Use of a helical composite free flap for alar defect reconstruction with a supermicrosurgical technique

  • Jeong, Hyung Hwa;Choi, Dong Hoon;Hong, Joon Pio;Suh, Hyun Suk
    • Archives of Plastic Surgery
    • /
    • 제45권5호
    • /
    • pp.466-469
    • /
    • 2018
  • The highly contoured nature of the nose and the abundant free margin makes it especially difficult to reconstruct. In this report, we describe the use of a new helical rim free flap technique for the reconstruction of full-thickness nasal alar defects via supermicrosurgery. Briefly, after a wide excision with a margin of 0.7 cm, an alar defect with a size of $1{\times}1{\times}0.5cm$ was obtained, which included the full thickness of the skin, mucosa, and lower lateral cartilage. Vessel dissection was performed in a straightforward manner, starting from the incision margin for flap harvest, without any further dissection for reach the greater trunk of the superficial temporal artery. The flap was inset in order to match the contour of the contralateral ala. We closed the donor site via rotation and advancement. No donor site morbidity was observed, despite the presence of a small scar that could easily be covered with hair. The alar contour was satisfactory, and the patient was satisfied with the results. The supermicrosurgical technique did not require further dissection to identify the vessels for anastomosis, leading to better cosmetic outcomes and a reduced operating time.

골막하 박리와 흡수성 봉합사에 의한 눈썹과 광대지방층의 거상술 (Eyebrow Lift and Malar Fat Lift by Absorbable Suture Fixation with Subperiosteal Dissection)

  • 정재훈;이윤호;장충현
    • Archives of Plastic Surgery
    • /
    • 제32권2호
    • /
    • pp.262-266
    • /
    • 2005
  • In some blepharochalasis patients, upper blepharoplasty alone is not satisfactory because of narrow distance between eyebrow and eyelash. On that occasion, eyebrow lift is advisable. There are many methods of classical eyebrow lift, such as direct excision, transblepharoplasty approach, anterior hairline technique, and so on. But they are not so effective, have a tendency to recur and also give rise to side effects; unacceptable scar, facial nerve palsy, sensory loss and hematoma, etc. Some patients who have prominent nasolabial folds, are reluctant to perform face lift procedure due to psychologic or economic burden. The authors performed the eyebrow lift procedure separately or simultaneously with face lift or forehead lift. After making 2 or 3 slit incisions, we passed absorbable suture material, 3-0 vicryl, through suborbicularis oculi fat layer. Then it was passed through subperiosteal plane and fixated to the temporalis fascia. When patients complain prominent nasolabial folds, malar fat pad was elevated also in the same manner. This methods is effective and has minimal complication such as facial nerve palsy, scar, sensory loss. Recurrent tendency was rarely observed during follow-up. Dimples were observed at slit incision sites but they disappeared within 2 or 3 weeks. Eyebrow lift and malar fat lift by absorbable suture elevation with subperiosteal dissection is a simple and less morbid. Because of its effectiveness and little side effect or complication, this procedure can be a useful method.

자발성 점막하 식도 박리의 치료 - 1례 보고 - (Spontaneous Submucosal Dissection of the Esophagus -Report of 1 Case-)

  • 이재영;김명천;김수철;박주철;최수철;이정일
    • Journal of Chest Surgery
    • /
    • 제31권3호
    • /
    • pp.329-335
    • /
    • 1998
  • 55세 남자환자가 흉부 불편감, 연하장애와 연하통을 주소로 입원하였다. 식도내압검사상 하부식도 괄약근의 이완이 전혀 관찰되지 않았다. 식도 조영술상 "double-barrelled 식도" 또는 점막 선조(mucosal stripe) 소견을 보였다. 내시경 검사상 상부 식도에 기관-식도누공의 형태를 보는 듯한 개구부가 있었다. 또한, 하부 식도에는 두군데의 점막 열창이 보였다. 이후 환자는 금식과 비경구적인 영양공급을 하면서 수주간 치료하였나, 증상의 호전을 볼수 없었다. 그래서 전신 마취하에 상부식도에 있던 가성내강의 개구부를 일차봉합하였다. 수술후 환자는 경한 연하곤란을 제외하고는 증상이 좋아졌다. 환자는 조심스런 경구섭취를 하고 퇴원하였다. 환자는 외래에서 추적검사상 발열이나 연하장애가 없었으며, 식도 조영술상 호전되는 양상을 보였다. 저자들은 보존적 치료와 수술적 치료를 시행했던 자발성 점막하 식도 박리의 특이한 경우를 치험하였다. 이에 관련된 문헌과 함께 보고하는 바이다. 보고하는 바이다.

  • PDF

만성 대동맥 박리증(DeBakey typeI) 환자의 전 대동맥 치환술 1례 보고 (Total Replacement of Aorta in Chronic Type 1 Aortic Dissection)

  • 홍종면;노윤우
    • Journal of Chest Surgery
    • /
    • 제30권3호
    • /
    • pp.336-339
    • /
    • 1997
  • 최근 흉부 대동맥의 수술적 치료가 과거에 비해 좋은 성적을 얻고 있다. 전 흉부 대동맥을 포함하는 대동맥류나 대동맥 박리증의 경우대개 두단계나세단계로나누어 수술하였다. 본원에서는 숲 대동맥을 포함한 드베키 타입 I 만성 대동맥 박리증 환자에 있어서 한번에 출 대동맥을 치환하는 수술을 시행하였다. 환자는 호흡 부전과 Marfan 환자의 특징적 외모를 갖고있는 25세 남자로 심한 대동맥 부전증과 만성 드베키 타입 I대동맥 박리증 진단하에 수술시행하였다. 수술소견상상행 대동맥이 매우 커져 있었으며 상행대동맥에 두 개의 내막 파열이 관찰되 었고 가혈관으로 부터 늑간 동맥들과 우측 신동맥이 혈공급을 받고있었다. 벤탈 술식과 함께 술 대동맥 치환술을 성공적으로 시행하였으며, 환자는 현재까지 큰 합병증없이 외래를 통해 추적 관찰중이다.

  • PDF

이중판막 재치환술 시 발생한 급성 대동맥 박리증으로 인한 비폐쇄성 장간막 허혈 (Nonocclusive Mesenteric Ischemia That Developed during Redo-double Valve Replacement Surgery, and This Was Caused by Acute Aortic Dissection)

  • 이삭;송석원;조상호;송승준;김관욱;장병철
    • Journal of Chest Surgery
    • /
    • 제42권2호
    • /
    • pp.248-251
    • /
    • 2009
  • 비폐쇄성 장간막 허혈(nonocclusive mesentericic ischemia, NOMI)은 개심술 후 약 0.05%에서 발생하는 아주 드문 합병증으로 주요 장 혈관의 폐색 없이 내장 말초 혈관의 심한 혈관 경련(vasospasm)에 의해 장 허혈이 발생하는 것을 일컫는다. 본 증례에서는 상행 대동맥을 통한 동맥관 삽입시 발생한 급성 대동맥 박리로 수분간의 저혈압 상태에서 상대적으로 중요한 심장과 뇌의 혈류를 유지하기 위한 장 혈관의 수축으로 NOMI가 발생한 경우로 비교적 빠른 진단과 치료가 이루어졌음에도 장 경색으로 진행되어 사망하였다. 임상적으로 NOMI가 의심되는 경우 조기 진단 및 치료만이 생존률을 높일 수 있으므로, 빠른 대동맥 조영술 및 혈관 확장제의 선택적 주입이 필요할 것으로 생각된다.

림프절 전이가 발견되지 않은(cN0) 유두상 갑상선 암의 중앙 경부 림프절 분석 (The Analysis of Central Cervical Lymph Nodes in Papillary Thyroid Carcinoma with Preoperative No Lymph Node Metastasis)

  • 김윤정;하태권;유성목;김상효
    • 대한두경부종양학회지
    • /
    • 제26권2호
    • /
    • pp.183-186
    • /
    • 2010
  • Purpose : Papillary thyroid carcinoma (PTC) is known for malignant tumor which has a favorable prognosis and long-term survival. Although the prognosis for patients with PTC is generally good, PTC tends to have highly metastatic property. The purpose of this study was to analyze the central compartment lymph node in papillary thyroid cancer with no lymph node metastasis clinically and to assess the significance of prophylactic node dissection. Methods : A retrospective review was carried out in 394 patients with PTC who underwent surgery for the period from January 2004 to December 2006. The positive rate of the lymph node metastasis was analyzed. The relations between the central compartment lymph nodes and the patients' age, gender, tumor size, exrathyroidal extension(ETE), multifocality, and bilaterality were comparatively analyzed in PTC patients with preoperative no lymph node metastasis. Results : The enrolled patients were 40 male and 354 female cases. The 118 cases of them were found to have cervical lymph node metastasis. The mean age was 46 years(range, 15-77years). Tumor size(p=0.000), ETE(p=0.001), multifocality(p=0.014), and bilaterality(p=0.001) were significantly related factors for cervical lymph node metastasis clinically in papillary thyroid cancer. However, age and gender were not significantly related with lymph node metastasis. Conclusion : Although no lymph node metastasis clinically, prophylactic neck node dissection can be performed to avoid risks of local recurrence and reoperation in the light of PTC nature. The pathological status and high positive rate of central compartment lymph node relate to tumor size and extrathyroidal extension. Close surveillance for nodal status is required in follow-up.

임산부에서 발생한 대동맥 박리 (Aortic Dissection) 1례 (An Aortic Dissection in Pregnant Woman -a case report-)

  • 이형민;홍은표;이동협;이정철;한승세;신동구;김영조;심봉섭
    • Journal of Yeungnam Medical Science
    • /
    • 제10권1호
    • /
    • pp.253-259
    • /
    • 1993
  • 본원에서는 출산 후 지속되는 호흡곤란, 전신부종을 주소로 내원한 환자에서 임신과 관계된 De Bakey유형II의 대동맥해리를 진단하고 성공적으로 수술을 시행한 1례를 경험하였기에 보고하는 바이다.

  • PDF

Systemic Analysis on Risk Factors for Breast Cancer Related Lymphedema

  • Zhu, Ya-Qun;Xie, Yu-Huan;Liu, Feng-Huan;Guo, Qi;Shen, Pei-Pei;Tian, Ye
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권16호
    • /
    • pp.6535-6541
    • /
    • 2014
  • Background: To evaluate risk factors for upper extremity lymphedema due to breast cancer surgery. Materials and Methods: Clinical studies published on PubMed, Ovid, EMbase, and Cochrane Library from January 1996 to December 2012 were selected. Results: Twenty-five studies were identified, including 12,104 patients. Six risk factors related to the incidence of lymphedema after breast cancer treatment were detected: axillary lymph node dissection (OR=3.73, 95%CI 1.16 to 11.96), postoperative complications (OR=2.64, 95%CI 1.10 to 6.30), hypertension (OR=1.83, 95%CI 1.38 to 2.42), high body mass index (OR=1.80, 95%CI 1.30 to 2.49), chemotherapy (OR=1.38, 95%CI 1.07 to 1.79) and radiotherapy (OR=1.35, 95%CI 1.10 to 1.66). We found significant protective factors for lymphedema: pathologic T classification (OR=0.57, 95%CI 0.36 to 0.91) and stage (OR=0.60, 95%CI 0.39 to 0.93), while some factors, like age, number of positive lymph nodes, number of lymph node dissection, demonstrated no obvious correlation. Conclusions: Axillary lymph node dissection, postoperative complications, hypertension, body mass index, chemotherapy, radiotherapy are risk factors for lymphedema after breast cancer treatment. Attention should be paid to patients with risk factors to prevent the occurrence of lymphedema.

Neuroprotective Effects of Lacosamide in Experimental Peripheral Nerve Injury in Rats : A Prospective Randomized and Placebo-Controlled Trial

  • Demiroz, Serdar;Ur, Koray;Bengu, Aydin Sukru;Ulucan, Aykut;Atici, Yunus;Erdogan, Sinan;Cirakli, Alper;Erdem, Sevki
    • Journal of Korean Neurosurgical Society
    • /
    • 제63권2호
    • /
    • pp.171-177
    • /
    • 2020
  • Objective : To evaluate the neuroprotective effects of lacosamide after experimental peripheral nerve injury in rats. Methods : A total of 28 male wistar albino rats weighing 300-350 g were divided into four groups. In group I, the sciatic nerve exposed and the surgical wound was closed without injury; in group II, peripheral nerve injuries (PNI) was performed after dissection of the nerve; in group III, PNI was performed after dissection and lacosamide was administered, and in group IV, PNI was performed after dissection and physiological saline solution was administered. At 7 days after the injury all animals were sacrificed after walking track analysis. A 5 mL blood sample was drawn for biochemical analysis, and sciatic nerve tissues were removed for histopathological examination. Results : There is low tissue damage in lacosamide treated group and antioxidant anzymes and malondialdehyde levels were higher than non-treated and placebo treated group. However there was no improvement on clinical assessment. Conclusıon : The biochemical and histological analyses revealed that lacosamide has neuroprotective effect in PNI in rats. This neuroprotective capacity depends on its scavenger role for free oxygen radicals by increasing antioxidant enzyme activity.

오토폼을 이용한 돼지 뒷다리 중량예측 연구 (Prediction of ham weight with the autofom in Korea)

  • 배진규;이영규;박범영;임효선;정봉수
    • 한국동물위생학회지
    • /
    • 제39권1호
    • /
    • pp.7-12
    • /
    • 2016
  • The Autofom is a equipment for predicting the amount of pig carcasses meat using the 16 ultrasonic sensors to measure in real time and it was established in Dodram LPC in Gyeonggi Province of Korea for the first time. This study was carried out to validate the reliability of Autofom statistically and to establish guideline for developing a analytic formula through comparing the measurement between Autofom and dissection. The ham parts of sixty-six pig carcasses were measured with Autofom and by two experimental performers. The weight means and standard deviations of ham parts including bone by measurements with Autofom and dissection were $10.69{\pm}0.81kg$ and $10.77{\pm}0.94kg$, respectively a strong positive correlation (P<0.01) was identified, with a coefficient of determination ($R^2$) of 0.82. The weight means and standard deviations of lean ham parts by measurements with Autofom and dissection were $7.41{\pm}0.58kg$ and $7.42{\pm}0.89kg$, respectively a strong positive correlation (P<0.01) was identified, with a coefficient of determination ($R^2$) of 0.72. The root mean square errors of two groups were 0.40 and 0.50, respectively.