• Title/Summary/Keyword: Definitive

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A comparison of retentive strength of implant cement depending on various methods of removing provisional cement from implant abutment

  • Keum, Eun-Cheol;Shin, Soo-Yeon
    • The Journal of Advanced Prosthodontics
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    • v.5 no.3
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    • pp.234-240
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    • 2013
  • PURPOSE. This study evaluated the effectiveness of various methods for removing provisional cement from implant abutments, and what effect these methods have on the retention of prosthesis during the definitive cementation. MATERIALS AND METHODS. Forty implant fixture analogues and abutments were embedded in resin blocks. Forty cast crowns were fabricated and divided into 4 groups each containing 10 implants. Group A was cemented directly with the definitive cement (Cem-Implant). The remainder were cemented with provisional cement (Temp-Bond NE), and classified according to the method for cleaning the abutments. Group B used a plastic curette and wet gauze, Group C used a rubber cup and pumice, and Group D used an airborne particle abrasion technique. The abutments were observed using a stereomicroscope after removing the provisional cement. The tensile bond strength was measured after the definitive cementation. Statistical analysis was performed using one-way analysis of variance test (${\alpha}$=.05). RESULTS. Group B clearly showed provisional cement remaining, whereas the other groups showed almost no cement. Groups A and B showed a relatively smooth surface. More roughness was observed in Group C, and apparent roughness was noted in Group D. The tensile bond strength tests revealed Group D to have significantly the highest tensile bond strength followed in order by Groups C, A and B. CONCLUSION. A plastic curette and wet gauze alone cannot effectively remove the residual provisional cement on the abutment. The definitive retention increased when the abutments were treated with rubber cup/pumice or airborne particle abraded to remove the provisional cement.

Clinical and radiobiological consideration of cyclical hypofractionated radiation therapy also known as QUAD Shot for neglected skin cancer disfiguring the face of a non-compliant patient who was refusing surgery and protracted radiation therapy: case report

  • Kil, Whoon Jong;Camphausen, Kevin;Cho, In Hye
    • Radiation Oncology Journal
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    • v.37 no.2
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    • pp.143-148
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    • 2019
  • Although surgery is the mainstay of local treatment for skin cancer, definitive radiation therapy (RT) has been also applied for patients who are unable to tolerate surgery. Definitive RT regimens usually consist of daily treatment for 4-7 weeks. Such protracted daily RT regimens, however, would not be feasible for non-compliant patients or patients who are unable to make multiple daily trips for weeks. Without treatment, however, skin cancers can continuously progress and cause distressing symptoms. A cyclical hypofractionated RT (QUAD Shot: 14 Gy in 4 fractions, twice-daily treatments with 6 hours interval on 2 consecutive days) can be a practical RT regimen for those patients. In this report, we present the successful treatment course of repeated QUAD Shots in a 79-year-old patient with neglected skin cancer that was disfiguring his face yet declined definitive surgery and protracted RT. We also evaluated and compared biologically equivalent doses between QUAD Shots and conventionally fractionated protracted RT regimens.

Surgical Treatment of Pulmonary Atresia with Intact Ventricular Septum (심실중격결손을 동반하지 않은 폐동맥폐쇄증에서의 교정수술)

  • Park, Seong-Hyeok;Kim, Yong-Jin;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.348-356
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    • 1989
  • Seventeen patients of pulmonary atresia with intact ventricular septum were underwent operation during 4.8years period from Jan. 1983 to Aug. 1988 at Seoul National university Hospital. The patients were composed of 8 males and 9 females, aging 1day to 2.5 years [mean 88 days]. We classified pulmonary atresia according to right ventricular morphology; those with tripartite ventricles in 12, those with no trabecular portion to the cavity in 0, and those with inlet portion only in 5. The tripartite approach to right ventricular morphology is helpful in selecting the type of initial palliative procedures. Palliative procedures were as follows; pulmonary valvotomy in 5 with 3 early survivors, mod B-T shunt in 4 with 3 early survivors, and palliative right ventricular outflow tract reconstruction in 4 with 1 early survivor. Effective preliminary palliation of pulmonary atresia are pulmonary valvotomy or palliative right ventricular outflow tract reconstruction in those with tripartite right ventricle, and modified Blalock-Taussig shunt in those with no infundibular portion. The approach to definitive repair is based primarily on the actual size of the tricuspid annulus and the right ventricular cavity. Definitive repair was as follows: definitive right ventricular outflow tract reconstruction in 4 with all survivors and mod. Fontan operation in 2 with one survivors. Right ventricular outflow tract reconstruction can be done as complete repair for patients who had adequate tricuspid annulus and right ventricular cavitary size and mod. Fontan operation for patients who severely hypoplastic tricuspid valve annulus or small right ventricular cavity.

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Percutaneous screw fixation and external stabilization as definitive surgical intervention for a pelvic ring injury combined with an acetabular fracture in the acute phase of polytrauma in Korea: a case report

  • Hohyoung Lee;Myung-Rae Cho;Suk-Kyoon Song;Euisun Yoon;Sungho Lee
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.298-303
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    • 2023
  • Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

The Effect of Trauma Team Approach on the Management of Hemodynamically Unstable Pelvic Bone Fracture: Retrospective Comparative study

  • Cho, Won-Tae;Cho, Jae-Woo;Kim, Jinil;Kim, Jin-Kak;Oh, Jong-Keon;Kim, Hak Jun;Kim, Namryeol;Cho, Jun-Min
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.139-145
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    • 2016
  • Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

Definitive radiotherapy with or without chemotherapy for clinical stage T4N0-1 non-small cell lung cancer

  • Kim, Yeon Joo;Song, Si Yeol;Jeong, Seong-Yun;Kim, Sang We;Lee, Jung-Shin;Kim, Su Ssan;Choi, Wonsik;Choi, Eun Kyung
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.284-293
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    • 2015
  • Purpose: To determine failure patterns and survival outcomes of T4N0-1 non-small cell lung cancer (NSCLC) treated with definitive radiotherapy. Materials and Methods: Ninety-five patients with T4N0-1 NSCLC who received definitive radiotherapy with or without chemotherapy from May 2003 to October 2014 were retrospectively reviewed. The standard radiotherapy scheme was 66 Gy in 30 fractions. The main concurrent chemotherapy regimen was $50mg/m^2$ weekly paclitaxel combined with $20mg/m^2$ cisplatin or AUC 2 carboplatin. The primary outcome was overall survival (OS). Secondary outcomes were failure patterns and toxicities. Results: The median age was 64 years (range, 34 to 90 years). Eighty-eight percent of patients (n = 84) had an Eastern Cooperative Oncology Group performance status of 0-1, and 42% (n = 40) experienced pretreatment weight loss. Sixty percent of patients (n = 57) had no metastatic regional lymph nodes. The median radiation dose was EQD2 67.1 Gy (range, 56.9 to 83.3 Gy). Seventy-one patients (75%) were treated with concurrent chemotherapy; of these, 13 were also administered neoadjuvant chemotherapy. At a median follow-up of 21 months (range, 1 to 102 months), 3-year OS was 44%. The 3-year cumulative incidences of local recurrence and distant recurrence were 48.8% and 36.3%, respectively. Pretreatment weight loss and combined chemotherapy were significant factors for OS. Acute esophagitis over grade 3 occurred in three patients and grade 3 chronic esophagitis occurred in one patient. There was no grade 3-4 radiation pneumonitis. Conclusion: Definitive radiotherapy for T4N0-1 NSCLC results in favorable survival with acceptable toxicity rates. Local recurrence is the major recurrence pattern. Intensity modulated radiotherapy and radio-sensitizing agents would be needed to improve local tumor control.

The Effects of Radiotherapy for Oropharyngeal Cancer ; A Single Institutional Experience (구인두 암에서 방사선 치료의 효과 ; 단일기관의 경험)

  • Choi, Euncheol;Kim, Ok Bae;Oh, Young Kee;Kim, Mi Young;Yeo, Chang Ki;Byun, Sang Jun;Park, Seung Gyu;Kim, Jin Hee
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.62-67
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    • 2014
  • Background and Objectives : To investigate the prognostic factors and effectiveness of radiotherapy for oropharyngeal cancer. Material and Methods : Forty seven patients in oropharyngeal cancer treated with radiotherapy between November 1989 and October 2010. Conventional radiotherapy was performed until July 2007 and conformal radiotherapy was performed since August 2007. Median age of patients was 59. Thirty five patients were males. Nine patients had operation. Patients treated with postoperative radiotherapy were delivered median 60 Gy and patients treated with definitive radiotherapy were delivered median 66 Gy. Median follow-up periods were 51 months. Results : Two year and 5 year overall survival rate was 78.7% and 59.9%. Two year and 5-year locoregional recurrence free survival rate was 82.3% and 72.9%. In subgroup of definitive radiotherapy, at univariate analysis for overall survival, lower N stage(p=0.01), lower stage(p=0.05) and well and moderate differentiation(p=0.001) were statistically significant. At univariate analysis for locoregional recurrence free survival, lower T stage(p=0.02) and better differentiation(p=0.043) were statistically significant. Treatment failure occurred in 12 patients. Locoregional recurrence(8 patients) was main pattern of failure. Conclusion : When definitive radiotherapy compared with postoperative adjuvant radiotherapy, there was no significant difference. Further studies would be needed to compare definitive radiotherapy with postoperative radiotherapy. N stage, stage and differentiation could be the prognostic factors for overall survival and T stage and differentiation could be the prognostic factors for locoregional recurrence free survival in patients treated definitive radiotherapy.

Full mouth rehabilitation with vertical dimension increase in patient with severely worn out dentition (과도한 마모를 가진 환자의 수직 고경 증가를 동반한 전악수복 증례)

  • Jung, Ji-Hye
    • The Journal of the Korean dental association
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    • v.54 no.6
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    • pp.438-446
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    • 2016
  • Severe tooth wear may cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance, pathogenic pulp and occlusal disharmony. Treating patients with severely worn dentition often requires full mouth rehabilitation with increasing vertical dimension. Proper diagnosis and treatment planning are important for esthetic and functional definitive restorations and the long term stability of the neuromuscular system and the TMJ. In this case, 66 year-old female presented with generalized worn dentition. Based on assessment, pathologic destruction of teeth structure on entire dentition was caused by masticatory force and diet habit without loss of vertical dimension. Subsequently, 3 mm increase of vertical dimension that based on incisor for tooth restoration and esthetic improvement was determined. After 8 weeks stabilization period with temporary fixed prostheses, definitive prostheses were fabricated. After 6 months follow up period, satisfactory outcomes were attained both functional and esthetic aspects through this procedure.

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Differentiation of three scuticociliatosis causing species in olive flounder (Paralichthys olivaceus) by multiplex PCR

  • Kim, Sung Mi;Lee, Eun Hye;Kim, Ki Hong
    • Journal of fish pathology
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    • v.17 no.2
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    • pp.145-149
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    • 2004
  • The definitive identification of ciliate species by morphological characteristics relies on time-consuming and laborious staining techniques. Therefore, in this study, we discriminated 3 scuticociliatosis causing species - Pseudocohnilembus persalinus, Uronema marinum and Philasterides dicentrarchi - in cultured olive flounder by multiplex PCR. The multiplex PCR based on the species-specific amplification of small subunit ribosomal RNA (SS rRNA) gene sequence enabled us to distinguish the 3 scuticociliate species in a simple and rapid manner, even in the sample containing the three species simultaneously. These data suggest that the multiplex PCR strategy would make it possible to avoid the cumbersome and time-consuming procedures of morphological analysis for the definitive identification of scuticociliates.