• Title/Summary/Keyword: Early fixation

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TWO CASES OF MASSIVE CRANIOFACIAL FIBROUS DYSPLASIA (광범위한 두개안면부 섬유성골이형성증의 치험 2례)

  • Kim, Jong-Ryoul;Chung, Gi-Deon;Kim, Hong-Sik;Kim, Ki-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.61-68
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    • 1996
  • In Fibrous dysplasia(FD) of the jaws, the majority of cases can await the cessation of growth before surgical intervention, and it seems prudent to delay surgery whenever possible until growth has ceased. In craniofacial FD, however, the dangers of dystopia, dystopia and loss of vision may require early surgery to prevent or control cranio-orbital complications. Delaying surgery in those circumstances may be significantly detrimental to such patients. Conservative surgical management of FD is widely practised and we advocate an extension to this conservative treatment by combining surgical recontouring with appropriate osteotomies if indicated, to achieve an optimal esthetic and functional results in craniofacial FD. One case will be presented to illustrate the feasiblility of such combined treatment, to report the uneventful healing of osteotomies in the FD of the jaws, and to demonstrate the use of titanium miniplate fixation in dysplastic bone. The other case had expansile disease of the left facial and fronto-temporal bones and osteolytic change left mandible. This patient complained of severe spontaneous bleeding of left mandibular premolar area and it was suspected as central hemangioma of the left mandible and craniofacial FD. Angiogram disclosed generalized dilation of the external carotid artery and its branches, especially terminal branches of the left facial and inferior alveolar arteries. But no specific abnormalities, such as A-V shunt, venous lake, or early venous drainage, was seen. So it was diagnosed craniofacial FD with hypercellularity and generalized bony recontouring was performed via coronal and transoral approaches.

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Replacement of the Xenograft Cardiac Valves (이종 조직판막의 재치환수술)

  • 김종환
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.619-629
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    • 1988
  • The increasing number of replacement of the substitute cardiac valves were seen in these 2 years. Out of a total 1,408 patients with cardiac valve replacement, 54 required replacement of the substitute valves. Fifty-nine substitute valves replaced were 43 in mitral, 14 in aortic and 2 in tricuspid positions; and they were 36 Ionescu-Shiley, 15 Hancock and 3 Angell-Shiley bioprosthetic valves and 3 St. Jude Medical and 2 Bjork-Shiley prosthetic valves. Primary tissue failure was the most frequent reason of replacement[38 patients] followed by paravalvular leak[9 patients], prosthetic valve endocarditis[6 patients] and valve thrombosis[1 patient] in order. The most pronounced pathology of the failed xenograft valves seen in the primary tissue failure group was calcification and fixation of the cusps with or without tear and defect of the cuspal tissue. The operative mortality rate was 7.4%. Fifty early survivors were followed up for a total of 82.6 patient-years and there was no late death. Actuarial survival rate was 92.3*3.8% at 6 years after surgery. Although the definite tendency toward early and accelerated degeneration of the xenograft valves has been seen in patients younger than 20 to 25 years of age, no strict age limit from where the tissue failure slows down could be determined. The requirement of the ideal substitute valves would be the durability of the recently developed mechanical prostheses armed with the low thrombogenicity of the bioprostheses. At the present time, the need of compromise in selection between less thrombogenic bioprosthetic and more durable mechanical valves should be stressed. The difficulty in choice is yet important in patients of middle age and children where the use of homograft valves may be one of the solution despite of certain limitations from sociomedical reasons.

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Experimental of Cerebral Vasospasm and Measure the Mean Blood Flow Velocity in the Middle Cerebral Artery

  • Park Byung-Rae
    • Biomedical Science Letters
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    • v.11 no.4
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    • pp.435-439
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    • 2005
  • To determine the appropriate concentration of papaverine hydrochloride(PPV) for therapeutic intraarterial infusion against cerebral vasospasm and to measure the mean blood flow velocity of the middle cerebral artery in rabbits. Vasospasm was induced in the experimental groups (3 days after infusion; group 1, n=3, 7 days after infusion; group 2, n=3) and a control group (n=l) by placing a blood clot in the subarachnoid space around the top of the internal carotid siphon. PPV (5 mg/kg) was infused into the internal carotid artery. The vascular diameters of the internal carotid artery (ICA) and middle cerebral artery (MCA) were measured on angiograms before and after infusion. The mean blood flow velocity in the MCA was measured on transcranial doppler sonograms before and 24 hours after infusion. After fixation, the MCA was dissected out, stained, and examined microscopically. After PPV infusion in both groups, vascular dilatation of about $20\%$ was seen. The mean increase in blood flow velocity in the group $1(30\%)$ was smaller than in the group $2(70\%)$. The mean blood flow velocity in the MCA decreased by about $30\%$ in both groups, but increased again after 24 hours nearly to the level before PPV infusion. PPV infusion may be more effective in early stages of vasospasm when vascular walls have fewer histologic changes.

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Treatment of Tibial Condyle Fracture (경골과 골절의 치료)

  • Lee, Dong-Chul;Shon, Oog-Jin;Park, Sung-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.177-186
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    • 2003
  • Background: Clinical and radiological results based on fracture types and associated injuries after the treatment of tibial plateau fracture were evaluated for analyzing prognostic factors. Materials and Methods: From June 1997 to June 2002, 50 cases were followed for at least 1 year. Mean age was 47.4 years, and mean follow period was 30.0 months. Fracture classification was performed by the Schatzker method. Clinical and radiological evaluation were performed by the Porter and Rasmussen method. Evaluation was based on degree of reduction and associated injuries, etc. Results: The most common cause of injury was traffic accident (37 cases, 74%), The common fracture types by Schatzker classification were type II (14 cases) and VI (12 cases). Methods of treatment were screw fixation (15 cases), plate and screw (21 cases), external fixator (5 cases), and conservative treatment (9 cases). The most common associated injuries were ipsilateral fibular fracture (18 cases) and MCL (medial collateral ligament) injury (8 cases). Conclusion: Acceptable results after treatment of tibial plateau fracture were obtained from the anatomical reduction group, non-associated injury group, the young age group, and the early ROM (range of motion) beginning group.

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Noninvasive Functional Therapy of Mandibular Condylar Fracture (기능적 처치에 의한 하악과두 골절의 치험 3례)

  • Park, Jin-Ho;Kim, Jong-Sup;Im, Nan-Hi;Yun, Hong-Sil;Chin, Byung-Rho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.398-404
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    • 1994
  • Functional recovery after mandibular condyle fracture was a contradictory result of many authors. The treatment goal of condyle fracture has been directed primarily toward restoration of functional movement of the mandible. We selected some patients who requested functional therapy in many cases of condylar fracture, depend on pattern of fracture, patient's demand, occlusion, age. Without intermaxillary fixation, we induced the patients to rapid healing of temporomandibular function and normal mandibular protrusive, lateral movement as a result of early functional therapy by activator. So, the authors report the cases with review of concerned literature.

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Dorsal Wedge Osteotomy Using Bioabsorbable Pins for the Treatment of Freiberg's Disease (중족골두 무혈성 괴사에서 생체흡수성 핀으로 고정한 배측 쐐기 절골술)

  • Gong, Hyun-Sik;Baek, Goo-Hyun;Kim, Ji-Hyeong;Chung, Moon-Sang
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.59-63
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    • 2005
  • Purpose: To present the procedure and results of dorsal wedge osteotomy fixated by bioabsorbable polyglycolide pins for the treatment of symptomatic Freiberg's disease. Materials and Methods: From January 1997 to December 2002, six patients with Freiberg's disease underwent dorsal wedge osteotomy of the metatarsal neck to bring the healthy plantar part of the metatarsal head into articulation. Bioabsorbable polyglycolide pins were used for the fixation and short-leg walking cast was applied for 4 weeks. Results: All patients returned to full daily activities without pain in three months after the operation. Radiographically, solid healing of the osteotomy was observed at average ten weeks. The active range of motion of the metatarsophalangeal joint increased by a mean gain of 30 degrees, and no complication such as displacement, osteolysis or sinus formation was observed. Conclusion: Dorsal wedge osteotomy fixated by bioabsorbable pins for patients with symptomatic Freiberg's disease is effective procedure that provides relatively early range of motion exercise and avoids second procedure for implant removal.

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Comparison Study of Open Reduction and Closed Reduction in Treatment of Mandibular Subcondylar Fractures (하악골 과두하부골절 정복술에서 관혈적 정복술과 비관혈적 정복술의 비교 연구)

  • Jang, Ju Yun;Kang, Dong Hee
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.51-54
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    • 2008
  • Purpose: The choice of open versus closed reduction for mandibular subcondylar fracture is a debatable issue. To evaluate the advantage of open approach to closed method with IMF(intermaxillary fixation), we conducted a retrospective study to compare the outcomes of each method. Methods: From 2002 to 2006, 29 patients with mandibular subcondylar fractures were treated by open or closed reduction. 17 patients were treated by open reduction and 12 patients by closed reduction and IMF. Each group was assessed for duration of mandibular immobilization, incidences of buccal palsy, malocclusion, TMJ(temporomandibular joint) pain, and deviation of the mandible on mouth opening. Results: All cases showed accurate reduction in anatomical position, no significant displacement and no deviation on mouth opening during the follow-up period. IMF period is statistically shorter in open reduction (p<0.05). Differences in incidence of other complications were not significant statistically. Conclusion: As there are significant independent morbidities associated with IMF which requires postoperative rehabilitation, prolonged temporomandibular immobilization should not be overlooked. Some patients with poor compliances will not tolerate IMF in nonsurgical treatment. In the aspect of patient's convenience and early recovery by short IMF period, open reduction would be recommended as a better treatment method.

Visualization of Thecal Plates of Lightly Armored Dinoflagellates Cryptoperidiniopsis brodyi and Pfiesteria piscicida (Dinophyceae) (유각 와편모조류 Pfiesteria piscicida (Dinophyceae)의 형태분석)

  • Park, Tae-Gyu;Bae, Heon-Meen;Kang, Yang-Soon
    • Journal of Environmental Science International
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    • v.18 no.1
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    • pp.15-19
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    • 2009
  • Early studies claimed that heterotrophic dinoflagellates Pfiesteria piscicida and related genera may produce a putative water-soluble toxin that causes death of fish and other marine animals. Several methods were tested to visualize plate morphology of Cryptoperidiniopsis brodyi and Pfiesteria piscicida. Cellulose plates of cells were exposed and visualized- by a membrane stripping method using Triton X-100. While calcofluor M2R white stain could readily bind to the thecal plates, details of the plate tabulation were difficult to observe. Fixation with osmium tetroxide $(OsO_4)$ produced well preserved cells with little morphological distortion, but thecal plates could not be visualized. Scanning electron microscopy (SEM) observation using the membrane stripping method showed distinctive plate tabulations between C. brodyi and P. piscicida suggesting that this method is a useful tool for morphological identification of lightly armored dinoflagellates.

Operative Treatment of Fractures of the Fifth Metatarsal Base (제5 중족골 기저부 골절의 수술적 치료)

  • Suh, Jin-Soo;Kim, Jung-Hoon;Choi, Jun-Young
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.189-196
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    • 2008
  • Purpose: Nonunions and delayed unions are possible complications of fractures of fifth metatarsal base. We tried to report the results of the surgical treatment, which is not prevalent yet. Materials and Methods: Retrospective study of thirty nine patients undergoing operation at our institution between 2003 and 2008 was conducted. Six patients were excluded with loss of follow up before bony union, multiple trauma, pediatric fractures, stress fracture, open fracture. There were 18 males and 15 females with 45.1 years old mean age. The average follow-up period was 18.3 months. We used a midfoot scoring system of AOFAS for clinical assessment and radiologic findings to evaluate bony union, alignment. Results: According to Lawrence's classification, Zone 1 fractures were thirteen and Zone 2 were twenty. Average AOFAS score was 93.61. Conclusion: Early operative treatment with cannulated screw fixation in fractures of the fifth metatarsal base is thought to be an useful and easy treatment option with faster rates of union.

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The effect of new bone formation of titanium mesh and demineralized freeze-dried bone (천공형 티타늄막과 탈회동결건조골의 신생골 형성에 대한 영향)

  • Lee, Yun-Ho;Park, Joon-Bong;Kwon, Young-Hyuk;Herr, Yeek;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.34 no.1
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    • pp.163-175
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    • 2004
  • This study was performed to evaluate bone formation in the calvaria of rabbit by the concept of guided bone regeneration with titanium mesh membrane and demineralized freeze-dried bone. The animal was sacrificed at 2 weeks, 4 weeks, 8 weeks, and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. 1. The titanium mesh but the biocompatibility was excellent the cell-occlusiveness was feeble. 2. The cell-occlusiveness was feeble and also the soft tissue growth of the upper part of the newly-formed bone after operating was excellent in early stage. 3. The maintenance ability of the space for the GBR very was excellent. 4. The titanium mesh the tissue-integration was superior the wound fixation ability excellent. 5. The demineralized freeze-dried bone did not promote the bone regeneration. 6. With the lapse of time, formation quantity of the bone some it increased, it increased quantity very it was feeble. Within the above results, the titanium mesh for the guided bone regeneration was excellent, the dεmineralized freeze-dried bone confirmed does not promote bone regeneration.