• Title/Summary/Keyword: 유착술

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Implant placement in severely atrophic mandible using alveolar ridge splitting procedure and small block bone graft: A case report of 4-year follow-up (심하게 위축된 하악 구치부에 치조제 분할술과 블록형 골이식술을 이용한 임플란트 식립: 4년 관찰 증례보고)

  • Kim, Na-Hong;Bang, Joo-Hyuk;Lee, Dong-Woon
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.64-73
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    • 2019
  • Various techniques have been developed, and the development of piezo electric devices have made it possible to widen the alveolar ridge even if the residual bone is dense or if there is a lack of cancellous bone between the cortical bones. In the operation of the mandibular posterior area, the flap is easily accessible to the ramus bone, from which high quality autogenous bone can be obtained, compared to other parts. A small autologous bone block can be used with particulated bone graft material using one screw for bone regeneration instead of a large autologous bone with two screws. The tapered implant design can minimize buccal bone fracture, even in severely atrophic mandibular areas. We report a case of 4 years following implant placement with ridge splitting and small autogenous bone graft in severly atrophic mandible. This report demonstrates a case of functional and aesthetic restoration in a patient through a collaboration.

Video Assisted Thoracoscopic Thoracic Sympathectomy for Palmar Hyperhidrosis (비디오 흉강경을 이용한 수장부 다한증의 흉부 교감신경절 절제술)

  • 류지윤;한일용;조광현
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.388-392
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    • 1998
  • Hyperhidrosis is one of abnormalities in autonomic nervous system, it has been treated with dermatologic principles or thoracic sympathectomy via thoracotomy. But these techniques were rather ineffective or invasive. Recently, Video Assisted Thoracoscopic Surgery(VATS) is widely applided in thoracic surgical area, and palmar & axillary hyperhidrosis is not the exception. From August 1995 to February 1997, 52 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic sympathectomy with VATS in the department of thoracic & cardiovascular surgery, Inje university, Pusan Paik Hospital. There were 27 men and 25 women and the mean age was 22 years. Mean operating time was 172 min and unilateral sympathectomy via minithoracotomy was applied in one patient due to severe pleural adhesion. Mean postoperative hospital stay was 2.6 days. During mean 12.5 months follow-up, there was no recurrence of sweating in the both hands. Thirty patients(57.7%) complained moderate degree of compensatory sweating, but the discomfort was decreased in severity. 83.8% of all patients were satisfied with the result of operation.

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Thoracoscopic Sympathetic Surgery for Axillary Hyperhidrosis (액와부다한증에서의 흉부교감신경절제수술)

  • 홍윤주;이두연;백효제;신화균;황정주;정은규
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1106-1110
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    • 1999
  • 배경: 다한증의 치료에 있어서 흉강경을 이용한 교감신경절제술의 시술 빈도가 급증하고 있다. 그러나 액와부 다한증의 경우 수장부나 안면 두부다한증에 비하여 절제범위가 광범위하여 이에 따른 보상성 다한증 및 기타 합병증의 발생의 높고 액취증이 동반되어있는 경우 장기적인 만족도가 낮아서 크게 각광 받지 못해왔다. 대상 및 방법: 본 교실에서는 1997년 3월부터 1999년 4월까지 45례의 액와부 다한증 환자에서 2 mm 흉강내시경을 이용하여 흉부교감신경절제술 또는 잘단술을 시행하였다. 남자 28례 여자 17례로 평균연령은 28(13-46세) 였고 평균추적기간은 10개월(1-24)이었다. 24례가 액와부에만 국한된 과도발한을 호소 하였고 2례에서 수술 전 심한 액취증이 동반되어있었다. 21례의 T3,4 교감신경절제술, 20례의 T2,4 교감신경단술 그리고 4례의 T4 교감신경절제수을 시행하여 즉각적인 증상치유효과 보상성 다한증 및 장기적 만족도를 비교 분석하였다. 중등도 이상의 흉막유착으로 5mm 내시경이 필요했던 2례을 제외한 전 환자에서 2mm 트로카 2개를 사용하여 수술을 하였다 결과: 평균수술시간은 T3,4 교감신경절제술이 46.2$\pm$11분 T2, 4 교감신경절단술이 32.5$\pm$23분 T4 교감신경절제술이 53.8$\pm$18분이 소요되었고 수술직후의 효과는 T3,4 교감신경절제술과 T2,4 교감신경절단술에서 '전혀땀이 나지 않는다'가 17례(81%) 와 12례(60%) '수술전보다 감소했으나 약간땀이 난다'가 4례(19%) 와 8례(40%) 로 모든 환자에서 효과가 있었으나 T4 교감신경절제술은 4례중3례(75%)에서 전혀 효과가 없었다. 보상성 다한증은 T3,4교감신경절제술과 T2,4 교감신경절단술에서 각각 67%, 60%로 나타났고 생활에 불편을 줄 정도의 심한경우는 10% 5%에 불과했으며 장기적인 만족도는 T3,4 교감신경절제술이 86% T2,4 교감신경절단술이 89%로 나타나 높은 성공률을 보았다 결론 : 액와부다한증의 치료에 있어서 T3,4 교감신경절제술과 T2,4교감신경절단술은 증상치유효과가 높고 절제범위의 제한에 따른 보상성 다한증의 감소로 장기적 만족도가 우수한 효과적인 방법이다. 액취증이 동반된 경우 이에대한 충분한사전 설명과 원인 감별후 적절한 보조요법을 병행함으로써 환자의 만족도를 높힐수 있다고 본다.

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The Effect of Hyaluronic Acid and Vitamin I Combination on Preventing Postoperative Intraperitoneal Adhesion Formation in Dogs (개에서 Hyaluronic Acid와 Vitamin E의 병용이 복강수술 후 유착방지에 미치는 효과)

  • Bae, Jae-Sung;Jang, Kwang-Ho;Kwon, Young-Sam;Jang, Hwan-Soo;Kim, Jung-Eun;Park, Se-Il;Lim, Jae-Hyun;Li, Wen-Xue;Lee, Seoung-Jin
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.42-48
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    • 2003
  • This study was performed to compare the effect of hyaluronic acid(HA), vitamin I and their combinations for the prevention of postoperative intraperitioneal adhesion in dogs. Twelve mongrel dogs were divided into four groups; HA- (HA Group), vitamin E 800IU- (E8 Group), HA + vitamin E 800IU- (HA+E8 Group) and HA + vitamin E 1600IU-treated group(HA+E16 Group) with three dogs in each group. After celiotomy, five abrasions of 1$\times$1 cm area were made on the antimesenteric serosal surface of the anterior ileocecum with a No. 10 scalpel blade. The five abrasions and peritoneal cavity were coated with 25 of 0.l% HA. Oral supplements of vitamin E were given from the fifth day before the operation to the fourteenth day after the operation. Hematologic values were evaluated before the operation and on the 1st, 4th, 7th and 14th day after the operation. The locations and scores of adhesion were assessed through the second operation on the 21st day after the first operation. The adhesions were located on serosa to mesentary(43.3%)), serosa to serosa(20%), serosa to omentum(5%) and serosa to parietal peritoneum(1.7%). The incidences of adhesion in HA, E8, HA+E8 and HA+E16 groups were 80%, 100%, 47% and 53%, respectively. The scores of adhesion in HA+E8 group(p < 0.05) were lower than those in other groups. This study showed that the combination of HA and vitamin E 800IU was significantly effective in reducing the intraperitoneal adhesion in dogs.

Large aspergilloma cavity treated by Cavernostomy md ometal, muscle flaps A case report (공동절개술과 유경성 대망이식술 및 근육 충진술을 이용한 거대 폐공동(폐국균증)의 치험 1례)

  • 방정희;편승환
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.936-940
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    • 1997
  • Pulmonary aspergilloma is potentially a life threatening disease resulting from the colonization of lung cavities by Aspergillus fumigatus. A case is reported: a 43-year-old man with symtomatic cavitary aspergilloma presenting with severe productive coughing, hemopt sis, occasional fever, and chilling. On preoperative plain chest radiograph and CT scan, we could find a rounded irregular opacity in a large pulmonary cavity. He received 2 separate operations for therapeutic need. At the first opertion, we performed cavernostomy and thoracoplasty because of severe pleural adhesions, tearing of cavity wall, and high risk of respiratory insufficiency. At the second operation, we performed myoplasty and omentoplasty for closure of remaining air space and complete wrapping of the BPF site. All symptoms of dyspnea and hemoptysis have since resolved. We believed that in the high risk patients who have severe respiratory symptoms, such as in aspergilloma and open cavity with a risk of respiratory insufficiency, cavernostomy followed by myoplasty or omentoplasty should be recommended.

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Video-assisted Talc Poudrage for the Treatment of Malignant Pleural Effusion: Analysis of Effects and Benefits (악성 늑막 삼출증에서의 비디오 흉강경하 탈크 분무의 효과 및 장점 분석)

  • Song, In-Hag;Chang, Won-Ho;Choi, Chang-Woo;Son, Jin-Sung;Kim, Dong-Hyun;Baek, Kang-Seok;Youm, Wook;Kim, Hyun-Jo
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.492-498
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    • 2007
  • Background: Malignant pleural effusion is a common condition in neoplastic patients and palliative therapy is the usual treatment. Talc has been generally accepted to be the most effective sclerosant for chemical pleurodesis, but the optimal route of administration remains controversy. We compared the results of video-assisted thoracoscopic talc poudrage (VTP) with administering a bedside talc slurry through a chest tube (BTS) for the treatment of malignant pleural effusion. Material and Method: From December 2004 to May 2006, 20 patients with malignant pleural effusion underwent chemical pleurodesis via VTP (group A, n=10), and BTS (group B, n=10). Result: The durations of chest tube placement after the procedure were $7.0{\pm}4.0$ days (group A) and $6.7{\pm}3.6$ days (group B). The hospital stays were $24.3{\pm}9.4$ days (group A) and $30.7{\pm}21.5$ days (group B), respectively. The symptoms of dyspnea were much more improved in group A (p-value=0.014) after discharge (mean f/u group $A=8.5{\pm}2.2$ months, group B $8.0{\pm}7.4$ months). The collapsed portions of lung were better expanded in group A than in group B (p-value=0.011). Conclusion: We recommend VTP for the selected patients with malignant pleural effusion because of the advantages of dissecting the fibrous peel to relieve the atelectasis and dyspnea, and excising the pleura for diagnosis with direct viewing of the lesion.

The Comparison of Video Assisted Thoracic Surgery (VATS) with 10 mm Thoracoscopy to 2 mm Thoracoscopy for Primary Spontaneous Pneumothorax (원발성 자연 기흉에서 10 mm와 2 mm 비디오 흉강경 수술의 비교)

  • Hwang Jin-Wook;Jo Won-Min;Min Byoung-Ju;Son Ho-Sung;Lee In-Sung;Shin Jae-Seung
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.627-632
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    • 2005
  • Background: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. Material and Method: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS blob resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mn VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. Result: The mean follow-up duration was 20,8$\pm$16.1 months in 10 mm VATS group, and 13.9 $\pm$8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax ($34\%$) in 10 mm VATS and patient's desire ($40\%$) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, $R^2$ values were lower than 0.1. The postoperative recurrence rate was $2.7\%$ in 10 mm VATS and $2.9\%$ in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. Conclusion: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.

FIBRIN SEALANTS IN MAXILLOFACIAL SURGERY : A INTRODUCTORY REPORT (악안면 외과 영역에서의 FIBRIN SEALANTS 의 이용)

  • Kim, Myung-Jin;Park, Hyung-Kook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.129-136
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    • 1991
  • The fibrin sealant was first designed as an alternative to surgical suture for the purpose of surface-to-surface union especially in parenchymal organs like the liver, spleen and kidney. The clinical application of currently used fibrin sealant was first introduced in 1972. The fibrin sealant consists of principal two components; lyophilized human fibrinogen and bovine thrombin. The fibrinogen component also contains coagulation factor XIII. A solution of aprotinin, an inhibitor of fibrinolysis is used to dissolve the fibrinogen and to provide the first component, and a solution of calcium chloride is also used to provide the second component. From July to December in 1990, during 6 months, we used fibrin sealant in the 28 patients of 33 various cases, in the following ways; supportive application of fibrin sealant after free autogenouse nerve graft for the repair of inferior alveolar nerve, facial nerve or accessory nerve, treament of hemangioma or lymphangioma to thrombosize and lead to the tumor shrinking, skin grafting to stimulate the adhesion and tissue repair, bone grafting in the patients of cleft alveolus, mandibular reconstruction or orthognathic surgery to facilitate the knitting of bone chips, tissue adhesion after tumor resection, radical neck dissection or flap reconstructions, and supportive adhesion of external auditory cannal after TMJ surgery via postauricular approach. No adverse effects were observed, none of the patients developed hepatitis or other blood transmitted disease, and the wound healing were acceptable.

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DELAYED REPLANTATION OF COMPLETELY AVULSED TOOTH (완전탈구된 치아의 지연 재식)

  • Han, Yu-Ri;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.555-560
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    • 2002
  • Replantation may be a treatment choice for a completely avulsed tooth caused by a traumatic injury. The outcome of replantation depends on the following factors ; minimal damage to pulp and periodontal membrane, the length of time the avulsed tooth was out of the mouth, how the tooth was stored, the level of root formation, etc. The time from the act of avulsion of the tooth to the actual replantation is especially important. Generally, when replanted within 30 minutes, more than 90% of the cases succeed, but when the time is between 30 to 90minutes, 43%, and greater than 90 minutes, 7%. This is a case of a replanted tooth with relatively good prognosis by ankylosis though there was a great time lapse since the tooth was avulsed. Though such treatment lead to loss of the tooth, in cases of children or adolescents, this treatment is meaningful, because it may earn time until any definitive therapy, functionally stimulate the alveolar bone to retain its height for a better prognosis for future treatment, and act as space maintainer.

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Massive Rotator Cuff Tear Repair (광범위 회전근 개 파열의 봉합술)

  • Shin, Sang-Jin
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.167-174
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    • 2010
  • Purpose: Anatomical repair of massive rotator cuff tear has been technically challenging because of medial retraction, muscle atrophy and fatty degeneration. Among several treatment options for massive rotator cuff tear, we reviewed rotator cuff repairs and investigated modalities for improvement of clinical outcomes, decreasing the re-tear rate, and increasing healing. Materials and Methods: Patient-related factors and rotator cuff-related factors were the two major groups of factors we considered when choosing a treatment plan. Results: Mobilization of a massive rotator cuff tear was increased by soft tissue release and by the interval slide technique. After meticulous soft tissue release, anatomical repair could be achieved. If the injury was not amenable to anatomical repair, alternative treatment options such as partial repair, the margin convergence technique and augmentation with a tenotomized biceps tendon were considered. Many reports of massive rotator cuff repair demonstrated satisfactory clinical outcomes, decreased pain, recovery of shoulder functions, and increases in muscle strength. However, the re-tear rate had been reported to be relatively high in long-term follow-up. Conclusion: Despite a high re-tear rate after massive rotator cuff repair, a better understanding of the pathogenesis, progression and clinical symptoms of massive rotator cuff tear and improved surgical materials and techniques will lead to satisfactory clinical outcomes.