• Title/Summary/Keyword: Correction Age

Search Result 510, Processing Time 0.025 seconds

Pain and Anxiety Management in Minimally Invasive Repair of Pectus Excavatum

  • Ghionzoli, Marco;Brandigi, Elisa;Messineo, Antonio;Messeri, Andrea
    • The Korean Journal of Pain
    • /
    • v.25 no.4
    • /
    • pp.267-271
    • /
    • 2012
  • The Nuss procedure for the correction of Pectus Excavatum (PE) is associated with intense postoperative pain. Our strategy to control early postoperative pain is to combine epidural with intravenous analgesia. Our aim was to analyse our pain control strategy by reviewing all the PE cases treated at our institution. Sixty consecutive patients, aged between 12 and 26 years old, received the PE operation at our institution from January, 2007 to September, 2010. The median age was 16 (12-27) with a male/female ratio of about 7/1. An epidural catheter was employed in all the cases, with 38 patients (63%) requiring additional drugs to control pain, which remained in place for 74 hours (72-96). The pain score was higher in male patients, but lower in those younger than 16 years old. Moreover, patients that consumed benzodiazepines had a significant decrease in cumulative opioid intake (P = 0.0408). Both gender and age had an impact on pain control, while we noticed a synergistic effect between opiates and tranquillizers.

CONDYLAR ANKYLOSIS : UNILATERAL POSTTRAUMATIC CONDYLAR PSEUDOANKYLOSIS (악관절 과두강직 : 편측성 과두강직을 동반한 안모비대칭 치료 증례)

  • Hong, Sung-Gyu;Hong, Sung-Joon
    • The korean journal of orthodontics
    • /
    • v.23 no.3 s.42
    • /
    • pp.427-445
    • /
    • 1993
  • The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

  • PDF

Correction of Bilateral Cleft Lip Using Modified Noordhoff Technique (개선된 Noordhoff 방법을 이용한 양측성 구순열의 교정)

  • Cho, Byung Chae;Lee, Yong Jig
    • Archives of Plastic Surgery
    • /
    • v.33 no.4
    • /
    • pp.399-406
    • /
    • 2006
  • Purpose: The authors accessed the anthropometric measurements of fourty non-cleft normal a three-month-old infant and using this obtained data as a basic guideline, authors applied the modified Noordhoff technique for the treatment of bilateral cleft lip. Methods: Over a period of 10 years, a total of 21 bilateral cleft lips were operated. 13 cases of complete and 8 cases of incomplete bilateral cleft lip and palate. In the complete type of bilateral cleft palate, elastic head cap and passive intraoral appliance were applied at 1 to 2 week of age for 2 months duration. The definitive cheiloplasty was performed at 3 months of age using the modified Noordhoff technique. Results: After a follow-up period ranging one to nine years, most patients presented with cosmetically and functionally satisfying results, with an exception of two cases where an undesired peaking effect of the vermilion and dimpling of the vermilion mucosa was encountered. Conclusion: Accessing the anthropometric measurements of fourty non-cleft normal three-month-old infant and using this obtained dara as a guideline, the modified Noordhoff technique can be applied to either complete or incomplete bilaterally cleft lip providing more naturally pleasing and cosmetically satisfying scars that lie in harmony with the philtral ridges, lip tubercle positioned just below the vermilion and a distinct white line and Cupid's bow.

Partial anomalous pulmonary venous connection with intact atrial septum in a child with ventricular septal defect: a case report

  • Kim, Young-Nam;Cho, Hwa-Jin;Cho, Young-Kuk;Ma, Jae-Sook
    • Clinical and Experimental Pediatrics
    • /
    • v.55 no.1
    • /
    • pp.24-28
    • /
    • 2012
  • Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.

Designed Compressive Strength Assurance Method of Management Period for Winter Concrete Using Blast Furnace Slag (한랭환경에서 타설되는 고로슬래그 시멘트 콘크리트의 설계기준강도 확보 기법)

  • Lee, Young-Jun;Lee, Hyuk-Ju;Han, Jun-Hui;Hyun, Seung-Yong;Seo, Hang-Goo;Han, Min-Cheol
    • Proceedings of the Korean Institute of Building Construction Conference
    • /
    • 2018.11a
    • /
    • pp.42-43
    • /
    • 2018
  • The research is to suggest the compensating strength values depending on various managing periods of concrete based on the strength development model calculated with equivalent age method for 20% of blast furnace slag replaced concrete. As a result, for 28 days of managing period, 9, 6, and 3MPa of compensating strength values were suggested when the temperatures were from 4 to 6℃, from 6 to 12℃, from 12 to 17℃, respectively. Additionally, for 42 days of managing period, 6 and 3MPa of compensating strength value was suggested when the temperature was from 4 to 7℃, from 7 to 12℃, and for 56 days of managing period, 3MPa of compensating strength value was suggested when the temperature was from 4 to 9℃. Furthermore, for 28, 42, 56, and 91 days of managing periods, any compensating strength values were needed when the temperature were higher than 17, 12, 9, and 4℃, respectively.

  • PDF

A Study of Intervention for Adolescent Idiopathic Scoliosis (청소년기 특발성 척추측만증의 중재에 관한 연구)

  • Kim, Seung-Joon
    • The Journal of Korean Physical Therapy
    • /
    • v.16 no.1
    • /
    • pp.60-69
    • /
    • 2004
  • Many methods have been described for the early intervention of adolescent idiopathic scoliosis. Adolescent idiopathic scoliosis is lateral and rotational spinal curvature in absence of associated congenital or neurologic abnormalities, the most common type of scoliosis observed in child and young adults, and refers to curves that develop after the age of $10{\sim}18$. The curves of adolescent idiopathic scoliosis have the potential to progress rapidly during growth. Curves are currently universally measured by the Cobb's method and Ferguson method. Some curves do not remain small, these may be mildly or severely progressive and the ribs on the convex side of the curve separate, and those on the concave side ribs approximate so rib undergoes deformation with rib humping. The latter may make angles that can affect vestibular system, balance, sensory, especially cardipulmonary function. Intervention for adolescent idiopathic scoliosis is based on the patient's age, the angular value of the curve, the maturity of their skeleton, and the topography. The purpose of intervention for adolescent idiopathic scoliosis consists of knowing how to go to the best approach the correction of the lateral curve and rotational deformity holding the achieved for the remainder of spinal growth, preventing significant cosmetic abnormality, pain and cardiopulmonary complication, control the muscle imbalance and proprioceptive postural disturbances, be less need for radical surgery to avoid early surgery.

  • PDF

Operative result congenital cardiac disease in adult - A reort of 725 surgical cases- (성인에서 선천성 심장기형의 수술성적 -725 치험례 보고-)

  • Lee, Jeong-Ryeol;Seo, Gyeong-Pil
    • Journal of Chest Surgery
    • /
    • v.19 no.1
    • /
    • pp.116-121
    • /
    • 1986
  • Patients over 15 years of age who have undergone a surgical correction of a congenital cardiac malformation during period of January 1958 through January 1986 have been reviewed. During this period there were 3957 congenital cardiac lesions consisting of 2712 acyanotic and 1245 cyanotic cases. Among them, a total of 725 adults [18.3%] with a variety of congenital heart lesions, 548 acyanotic group and 177 cyanotic group were operated on. 372 patients were male and 252 patients were female. There were 280 patients under 20 years of age, 206 between 20-24 years, 102 between 25-29 years, 48 between 30-34 and 89 over 35 years. The most common defects were atrial septal defect which accounted for 207 cases [28.6%] and other common anomalies were VSD [140 cases, 19.3%], TOF [136 cases, 18.6%], PDA [120 cases, 16.6%] and PS [33 cases, 4.6%] in order of incidence. Overall operative mortality for this series was 3.6% [1.8% of a cyanotic group and 9.0% of cyanotic group] compared with 2.8% of total cases of congenital heart disease [acyanotic group 1.1% and cyanotic group 6.5%]. This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

  • PDF

Maxillary protraction effects of TTBA (Tandem Traction Bow Appliance) therapy in Korean Class III children (한국인 성장기 III급 부정교합의 TTBA 치료 후 상악골 견인 효과)

  • Kim, Hye-Jin;Chun, Youn-Sic;Lim, Won-Hee
    • The korean journal of orthodontics
    • /
    • v.37 no.3 s.122
    • /
    • pp.231-240
    • /
    • 2007
  • Objective: The purpose of this study was to investigate the maxillary protraction effects of the Tandem Traction Bow Appliance (TTBA), a new appliance devised several years ago for the treatment of growing skeletal Class III patients. Methods: Participants were 88 Korean children (42 boys, 46 girls) with skeletal Class III malocclusion treated with TTBA at the orthodontic clinic of Ewha Womans University Mokdong Hospital. Mean age at the start of treatment was 7.5 years${\pm}$1.5 years. Mean treatment periods were $13{\pm}3$ months. Pretreatment and posttreatment lateral cephalograms were traced and superimposed by the same investigator and analyzed by modified McNamara analysis and pitchfork analysis. Changes were evaluated with paired t-tests at a significance level of p<0.05. Results: The maxilla and maxillary dentition moved forward. The mandible moved backward, although not significantly; and the mandibular dentition moved forward. The net dental changes combined with the apical base change resulted in a favorable total molar relationship correction. Net dental movement was 26% and the apical base change 74% of the total molar relationship correction. Conclusion: These results suggest that TTBA has a maxillary protraction effect that can be useful in the treatment of growing skeletal Class III malocclusion with maxillary deficiency.

Surgical Outcomes and Complications Following All Posterior Approach for Spinal Deformity Associated with Neurofibromatosis Type-1

  • Park, Byoung-Joo;Hyun, Seung-Jae;Wui, Seong-Hyun;Jung, Jong-Myung;Kim, Ki-Jeong;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
    • /
    • v.63 no.6
    • /
    • pp.738-746
    • /
    • 2020
  • Objectives : The purpose of this study was to evaluate surgical outcomes and complications of spinal deformity associated with neurofibromatosis type-1 (NF-1). Methods : From 2012 to 2018, patients suffering from spinal deformity associated with NF-1 who underwent surgical correction were identified. Demographic data and radiographic measures were retrospectively reviewed. Pre- and postoperative whole spine radiograph images were used to determine both coronal and sagittal Cobb angles. All of patients underwent 3-dimentional computed tomographic scan and magnetic resonance imaging scan to confirm dystrophic features. For evaluation of clinical outcomes, we surveyed the pre- and postoperative scoliosis research society-22r (SRS-22r) score. Results : Seven patients with spinal deformity associated with NF-1 were enrolled in this study. The mean age of patients was 29.5±1.2 years old. The mean follow-up period was 2.8±1.4 years. The apex of the deformity was located in cervicothoracic (n=1), thoracic (n=4), and lumbar region (n=2). Most patients have poor bone quality and decreased bone mineral density with average T-score of -3.5±1.0. All patients underwent surgical correction via posterior approach. The pre- and postoperative mean coronal and sagittal Cobb angle was 61.6±22.6° and 34.6±38.1°, 56.8±18.5° and 40.2±9.1°, respectively. Mean correction rate of coronal and sagittal angle was 44.7% and 23.1%. Ultimate follow-up SRS-22r score (average score, 3.9±0.4) improved comparing to preoperative score (average score, 3.3±0.9). Only one patient received revision surgery due to rod fracture. No serious complication occurred, such as neurological deficit, and viscerovascular injury. Conclusion : The surgical correction of patients having spinal deformity associated with NF-1 is challenging, however the radiographic and clinical outcomes are satisfactory. The all posterior approach can be a safe and effective surgical option for patients having dystrophic curves associated with NF-1.

Aesthetic outcomes after surgical repair of pectus excavatum in females: Differences between patients and professional evaluators

  • Wachter, Tanja;Frari, Barbara Del;Edlinger, Michael;Morandi, Evi Maria;Mayerl, Christina;Verstappen, Ralph;Celep, Emre;Djedovic, Gabriel;Kinzl, Johann;Schwabegger, Anton Herbert;Wolfram, Dolores
    • Archives of Plastic Surgery
    • /
    • v.47 no.2
    • /
    • pp.126-134
    • /
    • 2020
  • Background Pectus excavatum is less common in females than in males, and it often aggravates a coexistent breast asymmetry. We conducted a study comparing female patients' versus medical professionals' evaluation of pectus excavatum repair to assess differences in aesthetic outcome ratings. Moreover, we evaluated the influence of surgical correction on patients' self-perception. Methods Of 30 female patients who were initially screened, 18 patients (mean age, 20 years) who underwent bar removal after surgical correction of pectus excavatum deformity participated in the survey (60%). They completed a questionnaire rating their appearance before and after surgery and responded to a psychological questionnaire about the changes that they had experienced. The mean interval between pectus bar removal and evaluation was 28 months. Standardized preoperative and postoperative patient photographs were evaluated using the same questionnaire by a panel of medical professionals and students (n=24) and the results were compared. Results Patients rated their preoperative deformity as more severe than the other evaluators, revealing the significant impact of the deformity on patients' self-perception. Postoperatively, patient and professional evaluations were much better than before and were very similar. The psychological evaluation showed a clear improvement in well-being. The ratings of the medical professionals were not influenced by their degree of medical education. Conclusions Surgical correction of pectus excavatum in female patients positively influences body perception and psychological well-being. It should therefore not be considered as a merely aesthetic correction, but as an important procedure to restore a patient's self-perception.