• Title/Summary/Keyword: 수술시기

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EFFECT OF APF GEL ON THE SURFACE OF COMPOSITE RESIN (복합레진 표면에 대한 APF gel의 영향)

  • Yuk, Gun-Yeung;Yang, Kyu-Ho;Kim, Seon-Mi;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.1
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    • pp.43-52
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    • 2006
  • Topical fluoride application for children is a widely peformed procedure in the field of pediatric dentistry to prevent dental caries. However, it is recently recognized as having some unwanted effects on several esthetic restorative materials as it roughens the surface of the restorative materials. The aim of this study was to evaluate the surface changes in composite resins to topical fluoride. Composite resins(Z $250^{(R)}$, Ultraseal $XT^{(R)}$ Filtek $flow^{(R)}$ $Revolution^{(R)}$, $Denfil^{(R)}$) in topical fluoride agents were immersed and their surface roughness, weight loss and SEM were evaluated. The results were as follows : 1. The 4 minutes-immersion groups showed more roughened surface than 1 minute-immersion groups and the control groups showed the smoothest surface among all the materials, and there was statistically significant difference except the revolution between the groups. 2. There was no significant difference between the 1 minute-immersion groups and 4 minutes-immersion groups in weight loss. 3. The experimental group treated with topical fluoride gel showed the generally mere roughened surface than control group in the SEM findings.

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Temporal and Spatial Characteristics of Sediment Yields from the Chungju Dam Upstream Watershed (충주댐 상류유역의 유사 발생에 대한 시공간적인 특성)

  • Kim, Chul-Gyum;Lee, Jeong-Eun;Kim, Nam-Won
    • Journal of Korea Water Resources Association
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    • v.40 no.11
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    • pp.887-898
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    • 2007
  • A physically based semi-distributed model, SWAT was applied to the Chungju Dam upstream watershed in order to investigate the spatial and temporal characteristics of watershed sediment yields. For this, general features of the SWAT and sediment simulation algorithm within the model were described briefly, and watershed sediment modeling system was constructed after calibration and validation of parameters related to the runoff and sediment. With this modeling system, temporal and spatial variation of soil loss and sediment yields according to watershed scales, land uses, and reaches was analyzed. Sediment yield rates with drainage areas resulted in $0.5{\sim}0.6ton/ha/yr$ excluding some upstream sub-watersheds and showed around 0.51 ton/ha/yr above the areas of $1,000km^2$. Annual average soil loss according to land use represented the higher values in upland areas, but relatively lower in paddy and forest areas which were similar to the previous results from other researchers. Among the upstream reaches, Pyeongchanggang and Jucheongang showed higher sediment yields which was thought to be caused by larger area and higher fraction of upland than other upstream sub-areas. Monthly sediment yields at the main outlet showed same trend with seasonal rainfall distribution, that is, approximately 62% of annual yield was generated during July to August and the amount was about 208 ton/yr. From the results, we could obtain the uniform value of sediment yield rate and could roughly evaluate the effect of soil loss with land uses, and also could analyze the temporal and spatial characteristics of sediment yields from each reach and monthly variation for the Chungju Dam upstream watershed.

Isotopic Determination of Food Sources of Benthic Invertebrates in Two Different Macroalgal Habitats in the Korean Coasts (동위원소 분석에 의한 동해와 남해 연안의 상이한 해조류 군락에 서식하는 저서무척추동물 먹이원 평가)

  • Kang, Chang-Keun;Choy, Eun-Jung;Song, Haeng-Seop;Park, Hyun-Je;Soe, In-Soo;Jo, Q-Tae;Lee, Kun-Seop
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.4
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    • pp.380-389
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    • 2007
  • Stable carbon and nitrogen isotopes were analyzed in suspended particulate organic matter, macroalgae and macrobenthic invertebrates in order to determine the importance of primary organic matter sources in supporting food webs of rocky subtidal and intertidal macroalgal beds in the Korean coasts. Investigations were conducted at the inter tidal sites within Gwangyang bay, a semi-enclosed and eutrophicated bay, and the subtidal sites of the east coast, a relatively oligotrophic and open environment, in May and June 2005. Water-column suspension feeders showed more negative $\delta^{13}C$ values than those of the other feeding guilds, indicating trophic linkage with phytoplankton and thereby association with pelagic food chains. In contrast, animals of the other feeding guilds, including interface suspension feeders, herbivores, deposit feeders, omnivores and predators, displayed relatively less negative $\delta^{13}C$ values than those of the water-column suspension feeders and similar with that of macroalgae, indicating exclusive use of macroalgae-derived organic matter and association with benthic food chains. Most the macrobenthic species were considered to form strong trophic links with benthic food chains. In addition, the distribution of higher $\delta^{15}N$ values in macrobenthic consumers and macroalgae at the intertidal sites of Gwangyang Bay than those at the subtidal sites of the east coast suggests that anthropogenic nutrients may enhance the macroalgal production at the intertidal sites and in turn be incorporated into the particular littoral food web in Gwangyag Bay. These results confirm the dominant role of macroalgae in supporting rocky subtidal and intertidal food webs in the Korean coasts.

Coronary Fistulas -20 years experience - (관상동맥루)

  • Lee Jeong Ryul;Jung Yo Chun;Choi Chang Hyu;Kim Woong Han;Kim Yong Jin;Bae Eun Jung;Noh Chung Il
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.609-615
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    • 2005
  • Background: Some controversy still exists concerning the operative indications of coronary fistulas. Nevertheless, a short-term and long-term outcomes are excellent with surgical interventions. In this study, we assessed our surgical results on this disease entity during the last 20 years. Anatomic diversity was described as well. Material and Method: From April 1986 to March 2005, 20 patients with coronary fistulas underwent surgical correction in Seoul National University Children's Hospital. Their medical records were reviewed retrospectively. Result: Twelve patients ($60\%$) were asymptomatic prior to surgery. All had electrocardiogram and echocardiogram and all but 3 had coro-nary angiogram preoperatively. Anatomically, none of them had two or more coronary fistulas. The sites of origin were left coronary system in 11 patients and right in 9. The draining sites were right ventricle in 11, right atrium in 3, left ventricle in 3, main pulmonary artery in 2, and superior vena cavae in 1. All of the involved, the coro-nary arteries were dilated or aneurismal. In 1 case, there was atherosclerotic change but no ischemic evidence in preoperative electrocardiogram. Operative techniques included external obliteration (13), internal obliteration (5), and both (2). External obliteration was done by ligation of the fistulous tract only in T patients, by fstula ligation plus plication in 3 and by plication or patch closure via fistulotomy in 3. There was no operative mortality. All of postoperative morbidities including transient sinus arrhythmia (2), complete atrioventricular block (1), decreased left ventricular function (2), ventricular tachycardia (1), pericarditis (1), and seizure (1) improved on discharge. The mean follow-up was 55.1$\pm$50.2 months (4.0 months${\~}$18.0 years) and there were no recurrences of fistula. There was 1 second operation for aortic root aneurysm, which developed after external patch closure of right coronary fistula. Conclusion: We demonstrated here that coronary fistulas can be cured with excellent clinical outcome and low operative risk under precise diagnosis. Understanding the anatomic diversity will help to construct surgical plans.

Laparoscopy Assisted Total Gastrectomy with Lymph Node Dissection-77 Consecutive Cases (복강경 보조 위 전절제술-연속된 77예의 경험)

  • Lee, Joong-Ho;Song, Jye-Won;Oh, Sung-Jin;Kim, Sung-Soo;Choi, Won-Hyuk;Cheong, Jae-Ho;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.206-212
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    • 2007
  • Purpose: The number of laparoscopy assisted distal gastrectomies (LADG) is gradually increasing for the treatment of early gastric cancer (EGC) patients as a surgical modality for improving quality of life. However, there are few reports on laparoscopy-assisted total gastrectomy (LATG), mainly because this procedure is performed relatively infrequently, and the procedure is more complicated than LADG. This study was performed to evaluate the technical feasibility, safety, and surgical results of LATG with lymphadenectomy through a review of our experience. Materials and Methods: From July 2003 to June 2007, 77 LATG with Roux-en-Y esophagojejunostomy were performed for patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. Results: There were 49 males and 28 females in the study with a mean age of 61 years (range $30{\sim}85$ years). The mean operation time was 210 minutes (range $100{\sim}400$ minutes) and the operation time was gradually decreased as the case numbers increased. There were 13 operative morbidities (16.9%) and no operative mortalities. The restoration of bowel motility was noted at 3.2 postoperative days; a soft diet was started at 4.4 postoperative days and the duration of hospital stay was 10 days. There were 20 mucosal lesions, 32 submucosal lesions, 15 proper muscle lesions, 7 subserosal lesions and 3 serosal lesions. A total of 20 patients were treated by D2 lymph node dissection, 55 patients were treated by D1+$\beta$ lymph node dissection, and two patients were treated by D1+$\alpha$ lymph node dissection. The mean number of retrieved lymph nodes was 42 (range $11{\sim}86$). Lymph node metastases were noted in 12 patients. Conclusion: This study indicated LATG could be applied safely and effectively for patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for short-term and long-term surgical outcome is needed.

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Short-Term Results of Early Surgery for Active Infective Endocarditis (활동성 심내막염에 대한 조기 수술의 단기 성적)

  • 성기익;박표원
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.792-798
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    • 2002
  • Although there is a controversy on the optimal timing for active infective endocarditis(IE), recently good results of early surgical intervention have been published. Herein, we analyzed the results of surgery for active IE according to the duration of preoperative antibiotic treatment. Material and Method : Retrospectively, we analyzed 51 patients who underwent operation for active IE at the department of thoracic and cardiovascular surgery of Samsung medical center from Mar. 1995 to Oct. 2001. Male to female ratio was 39:12, mean age of the patients was 44.5$\pm$17.8 years(range : 13~74). Infected valves were mitral valve in 17(33.3%), aortic valve in 15(29.4%), mitral and aortic valve in 12(23.5), and tricuspid valve in 5(9.8%) cases. Among them, prosthetic valve endocarditis was present in 10(19.6%) cases. Infecting organism was Staphylococcus in 19(37.3%), Streptococcus in 17(33.3%), Enterococcus in 3(5.9%), fungus in 3(5.9%), and other bacteria in 5(9.8%) cases. Organism was not isolated in 6(11.8%) cases, and two organisms were isolated in 4(7.8%) cases. Dividing these patients into two groups according to the duration of preoperative antibiotic treatment(A: less than 7 days, B: more than 8 days), we compared the surgical results between the two groups. Result : There were 16 cases in group A and 35 in group B. Annular reconstruction was performed in 10(62.5%) cases in group A and 10(28.6%) cases in group B, which has statistically significance(p<0.05). There was one early death in group B. Forty nine patients(96.1%) except two were followed up with mean follow-up duration of 28.7 $\pm$ 23.6 months. Endocarditis was recurred in one in group A, and two in group B. Three late deaths occurred in group B. Recurrence rate and survival were not statistically different between the two groups. Conclusion : Early surgery for active IE showed good results as the result of that which was performed after prolonged antibiotic treatment; therefore, we believe that early surgery for active If could effectively eradicate the infection.

Outcome of Conservative Treatment of the Zone I, II 5th Metatarsal Base Fracture under Early Weight-Bearing (제5 중족골 제1, 2 구역 골절의 조기 체중부하의 비수술적 치료 결과)

  • Gwak, Heui-Chul;Park, Dae-Hyun;Kim, Jung-Han;Lee, Chang-Rack;Kwon, Yong-Uk;Kim, Dong-Seok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.150-156
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    • 2021
  • Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

Clinical Results of Treatment of Distal Biceps Rupture (이두박근 원위부 파열의 임상적 치료 결과)

  • Chung, Duke-Whan;Hwang, Jung-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.13-18
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    • 2009
  • Purpose: To report the clinical results of patients treated for a rupture of the distal tendon of biceps brachii Materials and Methods: Between February 1987 and March 2004, we treated 16 patients with a rupture of the distal tendon of biceps brachii. 9 of 16 patients underwent surgical treatment. All cases were male, median age was 26.3(range, 16-48) years. The mean interval between injury and surgery was 4.7 days (range, 1~36 days). Operative correction was performed anatomically, using the two-incision technique(3 cases) or one-incision technique(6 cases). Clinical outcomes were evaluated one year after operation by assessing the review about the physical examination finding and radiologic findings with surgical findings, range of motion, muscle strength, subjective satisfaction, activity and return to previous occupation. and via telephone interview in cases of conservative treatment. Results: In cases of surgical treatment, 85.8%, 86.3% of flexion-extension and supination-pronation motion than healthy side were measured respectively. 75% of flexion power than healthy side was measured. Eight of nine(89%) were very satisfied. Eightl of nine returned to original job. In cases of conservative treatment, 65% of flexion power than pre-injury state was reported. Four of seven were satisfied, two were dissatisfied, one was very dissatisfied. Three of seven returned to original job. Conclusion: Early anatomic reconstruction can restore more strength and endurance for supination and flexion range and power. Conservative management may be considered for partial injuries, but operative repair must be considered in complete rupture, athletes, patient with high activity.

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Correction of Secondary cleft lip-nasal deformity; secondary rhinoplasty in children and adults (구순열 이차비기형의 교정; 아동과 성인에서의 이차 비성형술)

  • Song Gin-Ah;Myung Hoon;Hwang Soon-Jung;Seo Byoung-Moo;Lee Jong-Ho;Choung Pill-Hoon;Kim Myung-Jin;Choi Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.17-25
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    • 2003
  • Correction of the cleft-lip nasal deformity is a difficult task that requires clear understanding of the associated complex anatomy and function as well as the operation time, the selection of an operation method, On the expectation that it helps enhance understanding the current trend of cleft-rhinoplasty, authors analyzed secondary rhinoplasty between 1999 and 2002, In both the unilateral and bilateral cleft lip rhinoplasty, we reviewed the timing of repair, site of correction and it's major technique, incision or approach method, autogenous cartilage graft method, All patients with a septal deviation did not have a septal surgery, We were active in alar and nasal tip surgery and passive in septal and dorsal deformity correction, And for children, we used a conservative method but for adults, we used radical approach, Most surgeries are focused on esthetic goal and we thought that objective evaluation for nasal obstruction was needed for bener and predictable outcome.

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Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate (잠김 금속판을 이용한 하지의 전이성 병적 골절에 대한 치료)

  • Seo, Chang-Young;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.80-86
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    • 2010
  • Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.