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Management of Bleeding Uterine Arteriovenous Malformation with Bilateral Uterine Artery Embolization
김태환,신지훈,김진우,윤현기,고기영,권동일,양희철,성규보 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.2
Purpose: To evaluate the technical feasibility and clinical outcome of bilateral uterineartery embolization (UAE) as a first-line therapeutic option for bleeding uterine arteriovenous malformation (AVM). Materials and Methods: Between 2002 and 2012, 19 patients were diagnosed with acquired uterine AVM clinically and through imaging studies. The clinical characteristics, angiographic features, technical success rate of embolization, procedure-related complications, imaging, and clinical follow-up data were assessed. Clinical success was defined as immediate symptomatic resolutionwith disappearance of vascular abnormality on subsequent imaging studies. Results: A total of 20 bilateral UAE, with or without embolization of extra-uterine feeders, were performed as the first-line treatment. Technical and clinical success rate was 90.0% (18/20) and 89.5% (17/19), respectively. Embolization was incompletein two patients who had residual extra-uterine fine feeders to the AVM or a procedure-related complication (ruptured uterine artery); the former showed slow regressionof the vascular malformation during the observation period, while the latter underwent a successful second bilateral UAE. Immediate clinical success was achieved in the remaining 17 patients after a single session and no recurrence of bleeding was found. Recovery to normal menstrual cycle was seen in all 17 patients with clinical success within one or two months, two of whom subsequently had uneventfulintrauterine pregnancies carried to term. Conclusion: Bilateral UAE is a safe and effective first-line therapeutic option for the management of bleeding uterineAVMs. However, incomplete embolization due to unembolizable feeders or difficultaccess into the uterine artery may lead to suboptimal treatment.
김태환,김소연,이상혁,진성민,Kim, Tae Hwan,Kim, So Yeon,Lee, Sang Hyuk,Jin, Sung Min 대한후두음성언어의학회 2015 대한후두음성언어의학회지 Vol.26 No.1
Hemangioma is one of the most common benign neoplasm, which occurs about 50% in head and neck region, but laryngeal hemangioma is relatively rare. Hemangioma occurred in larynx can be treated by surgical removal, cryosurgery, and steroid injection. Transoral CO2 laser micorsurgery has been known as useful method for the treatment of laryngeal hemangioma. We have experienced a 54-years old male patient of hemangioma originated in arytenoid area. This mass was removed via transoral approach with 'en bloc' resection by CO2 laser. We report this case regarding the treatment and prognosis of laryngeal hemangioma with review of literatures.