• Title/Summary/Keyword: 무절개 수술

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Radiographic evaluation of marginal bone level alteration around narrow implants placed in narrow alveolar ridge using guided flapless surgery (폭이 좁은 치조골에서 컴퓨터가이드를 이용한 무절개 임플란트 수술로 식립한 narrow implant의 방사선학적 평가)

  • Jeong, Seung-Mi;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.4
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    • pp.306-312
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    • 2020
  • Purpose: The aim of this study was to compare radiographic outcomes around narrow-diameter implants placed using guided flapless surgery at longer than 6 month post-placement. Materials and methods: A total of 12 implants were assessed in 12 patients for the sites where 0.5 - 1.5 mm labial bone was covering the implants, using CBCT. Results: A statistically significant preservation of crestal bone was observed in the narrow-diameter implants. Conclusion: Guided flapless implant surgery may be important in preventing bone loss around the narrow-diameter implants that are placed in narrow alveolar ridges.

Effect of Operative Wound Protection on Surgical Wound Complications (수술 증 절개창 보호 방법이 수술 후 절개창 합병증에 미치는 영향)

  • Lim, Jin-Hong;Kim, Sung-Soo;Choi, Won-Hyuk;Oh, Sung-Jin;Hyung, Woo-Jin;Choi, Seung-Ho;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.248-253
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    • 2007
  • Purpose: Surgical wound complications remain a cause of morbidity and mortality among postoperative patients, and the cost of caring for patients with a surgical wound complication is substantial. The purpose of this study was to evaluate the ability of a vinyl wound protector to reduce the rate of wound complications when used in clean-contaminated surgery. Materials and Methods: Between May 2006 and September 2006, 295 patients with a gastric cancer that underwent gastric surgery were studied prospectively, and the patients were randomized into one of two groups: the no wound protector group (n=137) or the polyethylene protector group (n=132). Results: The demographics and operation type and operation time were similar for patients in both groups. The rate of wound complication was different between patients in the no protector group (n=42) and the polyethylene protector group (n=12) (P=0.001) and the rates of seroma (P=0.001), infection (P=0.030) and dehiscence (P=0.282) were different for the two groups. The postoperative hospital stay was significantly shorter in the polyethylene protector group of patients (P=0.040). Conclusion: The use of a polyethylene protector resulted in a reduction of the surgical wound complication rate, and the cost of caring for patients, and morbidity and mortality among postoperative patients could be reduced.

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Application of digital implant system on implant treatment with "all-on-4" concept (디지털 임플란트 시스템을 전용한 "All-on-4" 개념의 임플란트 보철 증례)

  • Kim, Yong-Jun;Jeong, Seung-Mi;Kim, Kyeong-Hee;Fang, Jeong-Whan;Kim, Dae-Hwan;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.88-94
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    • 2018
  • Recently, digital implant systems are expanding its influence in dental area. Due to technical improvement, they jumped over their limits nowadays. We can use these newest systems to treat edentulous patient, from implant surgery to fabrication of prosthesis. In this case, The patient was a fifty years old female. She had a full edentulous ridge on mandible and wanted to reconstruct occlusion with using implants. We planned to use digital implant system with "all-on-4" concept on mandible and produced surgical guide for flapless implant surgery. After the surgery, we tried to fabricate full arch prosthesis just using a digital devices and confirmed satisfying result.

Fixed Prosthetic Restoration in an Edentulous Patient with NobelGuideTM System (양악 무치악 환자에서 NobelGuideTM 시스템을 이용한 고정성 임플란트 보철수복)

  • Shin, Hyoung-Joo;Kim, Dae-Gon;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.3
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    • pp.243-253
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    • 2009
  • This report described a technique utilizing a computer-aided design (CAD) /computer-aided machining (CAM) - guided surgical implant placement and prefabricated fixed complete denture for an immediately loaded restoration. A patient with an edentulous maxilla and mandible received 6 implants in maxilla and 6 implants in the mandible using CAD/CAM surgical templates. Prefabricated provisional maxillary and mandibular implant supported fixed prostheses were connected immediately after implant installation. Provisional prostheses were evaluated for aesthetics, function during 6 months. Definitive prostheses were fabricated.

Immediate Connection of Customized Zirconia Abutment Using Flapless Guided Surgery: A Clinical Report (무절개 수술을 이용한 맞춤형 지르코니아 지대주의 즉시 장착 증례)

  • Lee, Gyeong-Je;Choi, Byung-Ho;Kim, Hee-Jun;Jung, Seng-Mi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.201-212
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    • 2012
  • There are some similar aspects at histological and morphological characteristics between the peri-implant tissue and periodontal tissue and the direct attachment between the titanium and soft tissue around the implant called as "Functional ankylosis" can prevent the apical infiltration of inflammatory and bone resorption around implant. But, the repeated connection and disconnection of the abutment can destroy the mucosal barrier of soft tissue around the implant and can cause the marginal bone resorption. The amount of marginal bone resorption may reduced if the prosthetic abutment is placed at that time of surgery. Connection of the prosthetic abutment at surgery was limited because the low accuracy of conventional method, but by using of Cone Beam Computed Tomography(CBCT) and guide surgery, the 3-dimensional accuracy of implant placement became much higher than before and it became possible. This is a clinical case of immediate connection of prosthetic abutment and provisional restoration by using of precise CBCT diagnosis and pre-fabricated zirconia customized abutment at surgery and the alternative method is described in this article because of the clinically contentable results.

VATS Resection of Giant Leiomyoma of the Esophagus -1 case- (흉강경을 이용한 식도의 거대 평활근종 절제술 -치험 1예-)

  • 황호영;한국남;김주현;김영태
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.715-717
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    • 2004
  • A 59-year old woman visited us for incidentally detected posterior mediastinal mass. Preoperative esophagography, esophagoscopy, esophageal ultrasound and computed tomography showed a esophageal submucosal tumor. With the diagonsis of esophageal leiomyoma, the patient underwent right side video-assisted thoracoscopic surgery (VATS): The mediastinal pleura and the esophageal muscle layers were longitudinally opened and the tumor was enucleated. Esophagography performed at 6th postoperative day revealed no esophageal mucosal bulging or leakage. The patient was discharged reveiving a soft diet on the 7th postoperative day.

Neurilemmomas of the Cervical Vagus Nerve (경부 미주 신경에 발생한 신경초종)

  • Park Cheong-Soo;Suh Kwang-Wook;Kim Choon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.1
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    • pp.52-56
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    • 1991
  • 인체에서 발견되는 전체 신경초종중 $25{\sim}40%$가 두경부에서 발견되나 경부미주신경의 신경초종은 매우 희귀하여 1988년까지 영문문헌상 88 예가 보고되어 있다. 임상적으로 경부종괴가 주증상이며 때로는 애성, 종괴촉지시 기침 혹은 방사통, parapharyngeal space 의 종괴성장으로 연하곤란등이 초래되기도 한다. 치료는 종괴의 완전적출과 미주신경의 기능을 보존시키는 것이 주요 목표로 되어 있다. 저자들은 최근 5년간 4 예의 정부미주신경외 신경초종을 경험하였는데, 3 예는 측경부의 상부에, 1예는 측경부의 하부에 발생한 것이었다. 연령은 25세에서 50세까지 성인연령이었고, 성별은 남자 l 예, 여자 3 예이었다. 내원시 주소는 전예가 무통성 경부종괴이었으며, 종괴의 크기는 직경 3cm에서 10cm까지 다양하였다. 전예에서 종괴로 인한 신경학적 증상은 없었으나, 1 예에서 parapharyngeal space 의 거대종괴 때문에 다소간의 연하곤란이 있었다. 2 에에서는 종괴촉지시 기침이 유발됨을 호소하였다. 수술은 경부횡절개로 흉쇄유돌근을 제치고 총경 동맥과 내경정맥을 종괴의 상하부위가 완전히 노출되도록 박리한 후 종괴의 피막을 미주 신경의 주행방향에 따라 절개하여 적출 (enucleation) 하였다. 적출술시 종괴가 유착되어 있는 피막 부위는 동시에 절제하되 미주신경의 신경경로 (neural pathway) 는 유지되도록 하였다. 수술직후 2 예에서 일시적 애성을 호소하였다, 추적은 최단 20 개월에서 최장 80 개월까지 하였는데 일시적 애성은 호전되었고 전예가 재발없이 건강하게 지내고 있었다. 따라서 본 종양수술은 종양적출술시 이환된 미주신경의 절단을 결정하기 전에 신경경로를 유지시킬 수 있는 적출술 (enucleation) 을 먼저 고려하는 것이 바람직하다고 사료되었다.

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Closure of Atrial Septal Defects through a Video-assisted Mini-thoracotomy (흉강경하 최소절개를 이용한 심방중격결손의 폐쇄)

  • Min, Ho-Ki;Yang, Ji-Hyuk;Jun, Tae-Gook;Park, Pyo-Won;Choi, Seon-Uoo;Park, Seung-Woo;Min, Sun-Kyung;Lee, Jae-Jin
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.568-572
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    • 2008
  • Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.

Duodenal Duplication Cyst in a Korean Native Cattle (한우 송아지에서 발생한 십이지장의 중복낭종)

  • Kim, Jong-Min;Han, Tae-Sung;Park, Jin-Uk;Kang, Seong-Soo;Kim, Gon-Hyung;Choi, Seok-Hwa
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.546-548
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    • 2011
  • A congenital duplication cyst, which presents with symptoms of gastric outlet obstruction, is an unusual disorder in humans and a rare condition in animals. A 5-day-old male Korean native cattle was presented with anorexia and no defecation. On exploratory laparotomy, an oval shaped mass ($16{\times}7$ cm) was identified on the antimesenteric border of the proximal duodenum, with no communication between the intestinal lumen and the mass itself. Surgical correction for gastrointestinal tract patency was performed. The calf recovered well and was clinically normal three months after surgery. This case is the first report of a duodenal duplication cyst in a Korean native cattle.

CLINICAL EVALUATION OF THE INFLUENCE OF IONTOPHORESIS OF LIDOCAINE ON HEARING THRESHOLD (Iontophoresis에 의한 고막의 국소 마취후 청력역치변화에 관한 통계적 고찰)

  • 박재훈;박남미;이용배;채규룡;김병수;정수봉
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.9.2-9
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    • 1987
  • 외래에서 고막에 대한 간단한 수술을 시행함에 있어 고막의 국소 마취법으로 iontophoresis(전기 영동법)은 오래 전부터 널리 시행되어 왔으나 와우나 전정신경계에 대한 독성 때문에 논란의 대상이 되어 왔다. 1973년 Comeau이후 여러 학자에 의한 일련의 동물 및 인체 실험결과 lidocaine 의 iontophoresis는 안전하고 효과적인 방법으로 실제 임상에서의 사용을 권장하고 있으며 근년 널리 이용되고 있으나 iontophoresis를 시행함에 있어 기구 자체의 금속성 물질에 의한 독성 및 사용 약물의 내이 침투에 의한 영향에 관해서는 아직도 많은 연구가 진행되고 있다. 저자들은 1983년 부터 1986년 12월까지 고려병원 이비인후과에서 고막절개를 위해 iontophoresis에 의한 lidocaine의 국소마취법을 시행받은 환자중 무작위로 추출한 39명(46이)을 대상으로 iontophoresis시행 전후의 청력상의 변화에 관한 청각학적 고찰을 시행하여 iontophoresis후 청력 역치에 유의한 변화가 나타나지 않는다는 결과를 얻었다.

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