Background: Minimally invasive surgery of pectus excavatum by Dr. Nuss is a new technique that allows the repair of this deformity without any cartilage resection or sternal osteotomy We describe the early experiences with Nuss procedure. Material and Method: From December 1999 to January 2001, twenty patients with pectus excavatum underwent repair by Nuss procedure There were 14 males and 6 females whose mean age was 10.1$\pm$7.7 years, ranging from 1 to 33 years. Most patients(N=19) were below 20 years, except 33 years old female patient(N=1). Result: The severity of depression was assessed by computed topography(CT). CT index was mean 4.9$\pm$5.7(ranged from 3.3 to 8). The average operating time was 85.8$\pm$23.7 minutes. The used metal bars were ranged in length from 8 inches to 16 inches(average 11.8$\pm$14.4 inches). Early postoperative complications were pneumothorax in three patients, paralytic ileus in one, and postoperative chest pain requiring analgesics in all patients. Epidural analgesia was used in one adult patient for control of postoperative pain. In our experiences, there were no serious complications posteoperatively. Conclusion: There were good early results with the Nuss procedure that we performed for repairing of pectus excavatum. However, we believe the procedure needs to be observed for the long term results for it to be broadly accepted.
Kim, Jooho;Heo, SuYoung;Na, Jiyoung;Kim, Namsoo;Lee, Kichang;Jeong, Seongmok;Lee, HaeBeom
Journal of Veterinary Clinics
/
v.32
no.6
/
pp.481-485
/
2015
The present study determined the normal reference ranges for overall pelvic limb alignment of small-breed dogs. For this purpose, 60 cadaveric canine pelvic limbs from normal small-breed dogs (Maltese, Poodle, Shih Tzu, Yorkshire Terrier). A frontal full-limb radiograph of each pelvic limb was obtained, and mechanical tibiofemoral angle (mTFA), mechanical metatarsotibial angle (mMTTA), mechanical axis-femur angle (MAFA), and mechanical axis-metatarsus angle (MAMTA) were measured from each radiograph, along with mechanical deviation of the stifle (SMAD) and tarsal joints (TMAD). The 95% CI for radiographic values of all pelvic limbs were mTFA, 5.7-7.4; mMTTA, $-2.2--0.8^{\circ}$; MAFA, $3.5-4.5^{\circ}$; MAMTA, 1.0-2.0; SMAD, 2.1-2.7%; TMAD, 0.5-1.0%. There values varied among the breeds, except for mTFA. The reference ranges can be used for diagnosing pelvic limb deformities in small-breed dogs and for planning corrective osteotomies.
Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Kim, Dong Ha;Lee, Sang Weon;Song, Geun Sung
Journal of Korean Neurosurgical Society
/
v.60
no.5
/
pp.577-583
/
2017
Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.
Kong, Jung Sik;Jung, Jae A;Kang, So Ra;Kim, Yang Woo;Jeon, Young Woo
Archives of Craniofacial Surgery
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v.12
no.2
/
pp.93-96
/
2011
Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.
Background: Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of maxillofacial growth patterns in adult cleft lip and palate patients. Materials and Methods: The material for this study consisted of 17 adult male patients with cleft lip and palate. Cephalometric tracing and measurements were done by one investigator. The relationship between 17 cleft lip and palate patients and Korean norms were evaluated statistically. Results: There were statistically differences in Na. perpendicular to point A, SNA angle, effective maxillary length, maxillofacial differencial. Wit's appraisal and upper incisor to point A(p < 0.01). Pogonion to Na. perpendicular also statistically differed(p < 0.05). Other measurements didn't statistically differ. Conclusion: It was evident that in adult cleft lip and palate patients, maxilla was retruded and short. Careful cleft lip and palate repair and treatment are recommended for facilitating normal growth of maxilla.
Predehydration effects for cryopreservation in -196$^{\circ}C$ liquid nitrogen were studied in Korean native Aquilegia buergeriana var. oxysepala Kitamura and A. flabellata var. pumila Kudo seeds. Aquilegia species seeds were adjusted to moisture contents between 3.2 and 9.7% by air dry treatments. Seeds were placed in paper envelopes after submerged in liquid nitrogen and rewarming in 38 $^{\circ}C$ water. Seeds moisture contents by duration of drying were identified as controlling factors in the survival of Aquilegia species seeds for cryopreservation. Aquilegia species seeds having approximate 5% moisture content were able to withstand cooling to -l96$^{\circ}C$. Undehydrated seeds of Aquilegia buergeriana var. oxysepala Kitamura after being cryopreservated in liquid nitrogen have a 10.9% of moisture content and show 52.5% in germination. But, Aquilegia buergeriana var. oxysepala Kitamura seeds dehydrated by drying for 60 min. to have 6.0% of moisture content before cryopreservation show 84.7% in germination test. Properly dehydrated seeds after being stored in liquid nitrogen showed over 60% in germination rate and also shows an uniform sprouting time,11~13 days in average. Any morphologically deformity in germinating beds has not been observed. Results from this study suggest that Aquilegia species seeds can cryopreservation in liquid nitrogen if the seed moisture content is controled by a proper amount of dehydration.
Park, Hyung Seok;Lee, Jun Young;Ko, Kang Yeol;Ryu, Jehong;Lim, Jae Hwan
Journal of Korean Foot and Ankle Society
/
v.24
no.4
/
pp.129-134
/
2020
Purpose: This study compared the results of proximal and distal chevron osteotomy in patients with severe hallux valgus. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include severe hallux valgus. Materials and Methods: This study analyzed 127 severe hallux valgus surgeries. Of these, 76 patients (76 feet) were excluded for lack of adequate follow-up and additional procedures (Akin procedure), leaving 51 patients (51 feet) in the study. The mean age of the patients was 58 years (21~83 years), and the mean follow-up duration was 18 months (12~32 months). The patients were divided into two groups. Group 1 underwent distal chevron osteotomy, and group 2 underwent proximal chevron osteotomy performed sequentially by a single surgeon. The patients were interviewed for the American Orthopaedic Foot and Ankle Society (AOFAS) score before and one year after surgery. The anteroposterior weight-bearing radiography of the foot was taken before and one year after surgery. Results: There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and an increase in the AOFAS score. Significant improvement of the hallux valgus and intermetatarsal angle corrections was observed in both groups, and the sesamoid position was similar in each group. More improvement in radiographic correction of intermetatarsal angle was noted in group 2. Both procedures gave similar good clinical and radiological outcomes. Conclusion: This study suggests that a distal chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting severe hallux valgus as a proximal chevron osteotomy with a distal soft-tissue procedure.
Objective : To investigate the radiographic characteristics of the uppermost instrumented vertebrae (UIV) and UIV+1 compression fractures that are predictive of revision surgery following long-segment spinal fixation. Methods : A total 27 patients who presented newly developed compression fracture at UIV, UIV+1 after long segment spinal fixation (minimum 5 vertebral bodies, lowest instrumented vertebra of L5 or distal) were reviewed retrospectively. Patients were divided into two groups according to following management : revisional surgery (group A, n=13) and conservative care (group B, n=14). Pre- and postoperative images, and images taken shortly before and after the occurrence of fracture were evaluated for radiologic characteristics Results : Despite similar degrees of surgical correction of deformity, the fate of the two groups with proximal junctional compression fractures differed. Immediately after the fracture, the decrement of adjacent disc height in group A (32.3±7.6 mm to 23.7±8.4 mm, Δ=8.5±6.9 mm) was greater than group B (31.0±13.9 mm to 30.1±15.5 mm, Δ=0.9±2.9 mm, p=0.003). Pre-operative magnetic resonance imaging indicated that group A patients have a higher grade of disc degeneration adjacent to fractured vertebrae compared to group B (modified Pfirrmann grade, group A : 6.10±0.99, group B : 4.08±0.90, p=0.004). Binary logistic regression analysis indicated that decrement of disc height was the only associated risk factor for future revision surgery (odds ratio, 1.891; 95% confidence interval, 1.121-3.190; p=0.017). Conclusion : Proximal junctional vertebral compression fractures with greater early-stage decrement of adjacent disc height were associated with increased risk of future neurological deterioration and necessity of revision. The condition of adjacent disc degeneration should be considered regarding severity and revision rate of proximal junctional kyphosis/proximal junction failures.
This study sets out to investigate the installation of royal kilns and its impact on local kilns, taking note of celadon vase with inlaid cloud pattern in Joseon Dynasty. For that purpose, it determined the kilns and period to produce celadon vases with inlaid cloud pattern, and compared them with the pattern, design, and deformity of the celadon vases produced in the royal kilns in the 15th centuries. The celadon vase with inlaid cloud pattern was superior in quality than the porcelain for tribute ware manufactured together in Jeolla Province before the installation of royal kilns. And then a majority of sagijangs at local kiln had difficult time securing enough supply of manpower and resources, and discontinued manufacturing the celadon vase with inlaid cloud pattern. En revanche, celadon vases with inlaid cloud pattern produced from specially fixed royal kilns reflected the local sagijang's skill. Local kilns were strongly influenced by the installation of royal kilns. Those could not freely use high-quality white clay, limited to the market. Besides, most of the skillful sagijangs were assigned to royal kilns. Celadon vases with inlaid cloud pattern can be used as evidence to show that the manufacturing technique was transferred from local kilns to the royal kilns as well as to show that their production in royal kilns soon became stabilized.
Objective : Cervical surgery in patients with cervical spondylotic myelopathy (CSM) and cerebral palsy (CP) is challenging owing to the complexities of the deformity. We assessed factors affecting postoperative complications and outcomes after CSM surgery in patients with CP. Methods : Thirty-five consecutive patients with CP and CSM who underwent cervical operations between January 2006 and January 2014 were matched to 35 non-cerebral palsy (NCP) control patients. Postoperative complications and radiologic outcomes were compared between the groups. In the CP group, the Japanese Orthopaedic Association score; Oswestry neck disability index; modified Barthel index; and values for the grip and pinch, Box and Block, and Jebsen-Taylor hand function tests were obtained pre- and postoperatively and compared between those with and without postoperative complications. Results : Sixteen patients (16/35%) in the CP group and seven (7/35%) in the NCP group (p=0.021) had postoperative complications. Adjacent segment degeneration (p=0.021), postoperative motor weakness (p=0.037), and revisions (p=0.003) were significantly more frequent in the CP group than in the NCP group; however, instrument-related complications were not significantly higher in the CP group (7/35 vs. 5/35, p=0.280). The number of preoperative fixed cervical deformities were significantly higher in CP with postoperative complications (5/16 vs. 1/19, p=0.037). In the CP group, clinical outcomes were almost similar between those with and without postoperative complications. Conclusion : The occurrence of complications during the follow-up period was high in patients with CP. However, postoperative complications did not significantly affect clinical outcomes.
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