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방선우 대한영상의학회 1995 대한영상의학회지 Vol.32 No.5
Purpose : To assess the role of the preoperative portal vein embolization (PVE) in patients in need of majorhepatectomy. Materials and Methods : Total of 11 cases consisted of Klatskin tumor (n=6), gallbladder cancer(n=2), and hepatocellular carcinoma (n=3). After percutaneous transhepatic puncture of portal vein (right : 7,left : 4), the embolization of 1st order branch of right portal vein was done with Gentamicin soaked Gelfoamcubes. Radiologically, the angle between the middle hepatic vein and the inferior vena cava was measured on pre-and post-PVE CT (F/U: 10 days) to evaluate the hypertrophy of the left lobe. Clinically, amount and nature of thedrained bile drained through the PTBD tube of both lobes were analyzed in 5 patients with Klatskin tumor. Theinterval between PVE & operation was 10-24 days. Operative findings & the changes of postop. total bilirubin wereanalyzed and the complication after procedure was checked. Results : There was decrease in mean angle between themiddle hepatic vein and the inferior vena cava from 35.9 degree to 23.9 degree, but it was insignificantstatistically (p=0.09). The embolization of right portal vein was done and there was increase in amount of drainedbile from the nonembolized left lobe by 2-3 folds 8-14 day after PVE. The color and consistency between both lobeswere significantly different; right lobe was darker in color and softer in consistency. Postoperative totalbilirubin increased by 2-3 folds 1 to 4 days after PVE and normalized 10 to 14 days after PVE. Most of thepatients had mild abdominal pain and fever after PVE and 1 patient had localized hematoma at puncture site whichwas subsided spontaneously. Conclusion : The preoperative portal vein embolization is a useful method forminimizing postoperative liver failure in patients in need of major hepatectomy.
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골격선 Ⅲ급 부정교합 환자의 양악수술시 수술전 예측치와 수술후 실측치 차이에 관한 연구
박준호,황충주 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.3
The purpose of this study was to find out and evaluate discrepancies between exact and prediction values in ClassⅢsurgical patients. 26 patients(male 12, female 14) who were diagnosed as skeletal ClassⅢ and experienced presurgical orthodontic treatment and orthognathic surgery au Y university dental hospital were selected for this study. Lateral cephalograms were analyzed at prediction(T₁),immediately after surgery(T₂), 1 years after surgery(T₃),and specified the landmark as coodinates of X and Y axes. The samples were divided into 2 groups depending on the rotation point of maxilla(A point vs Incisal Edge). The statistical tools was SAS program and the statistical significance was tested. The results were as follows: 1. Changes of hard tissue points (T₁- T₂) in X corrdinates of ANS, A and in y coordinates of Me, Gn, Pg, B,Ii were statistically significant. 2. Change of soft tissue points (T₁- T₂) in X and y corrdinates of Pn,Sn,STA,Ls,Li were statistically significant. 3. Statistically significant changes in maxillary surgery rotated at A point were in X corrdinates of LS,Li and in y corrdinates of Me, Gn, Pg, B,Ii, Gn' and in x,y corrdinates of Pn,Sn,STA. 4. Statistically significant changes in maxillary surgery rotated at Incisal edge were in x corrdinates of ANS,A, Pn, Sn and in y corrdinates of Me, Gn, Pg, B,Ii,Is,Ls,Li,Gn' and in x,y corrdinates of STA. 5. There were significant differences in Is, Pns,Pn compared between A point group and incisal edge rotation group. 6. The maxillary plane angle showed significant difference at T₂- T₃(p<0.05), and occlusal planes of maxilla and mandible did not show significant change after surgery. As followed above results, the changes between prediction and exact measurements were considered separately at all landmarks and relapse amount according to surgery were also condsidered to achieve more resonable surgical results.
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