• 제목/요약/키워드: Flap

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Polylactic/Polyglycolic copolymer 차단막의 이개부 병소의 치유 효과 (Effects of the Guided Tissue Regeneration Using Polylactic/Polyglycolic Copolymer Membrane in the Furcation Involvement)

  • 허지선;김현영;김창성;최성호;조규성;채중규;김종관
    • Journal of Periodontal and Implant Science
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    • 제31권2호
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    • pp.345-356
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    • 2001
  • The purpose of the present study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) using resorbable polylactic/polyglycolic copolymer(PLA/PGA) membrane in mandibular class II furcation involvement and to compare it to the clinical efficacy of only flap operation. Both procedures were conducted in 5 patients with class II furcation involvements. After 6 months of follow up, the probing pocket depth, clincial attachment level, bone probing depth, and radiographic changes were compared, and the following results were obtained: 1. GTR using PLA/PGA demonstrated a statistically significant reduction in probing pocket depth and bone probing depth, and the control group demonstrated a statistically significant reduction in bone probing depth. 2. The comparison between the experimental and control group failed to demonstrate statistically significant difference in clinical improvement, but more reduction in probing pocket depth and bone probing depth were observed in the experimental group. The probing pocket depth and the bone probing depth were $2.2{\pm}1.6mm$ and $2.4{\pm}1.1mm$ respectively in the control group, while they were $2.4{\pm}1.3mm$ and $3.0{\pm}1.2mm$ respectively in the experimental group. 3. Radiographic change was not detectable for the both groups during the 6 months of follow up. 4. Sites with deeper probing pocket depth at baseline examination showed greater amount of clinical improvement in both groups. Other clinical factors didn't have any significant effect on the treatment results. It is concluded that though there are some limitations, PLA/PGA membrane is effective for the treatment of mandibular class II furcation involvement.

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가토의 치조열 모델에서 골수 흡인물이 자가뼈 이식술에 미치는 효과 (Effect of Bone Marrow Aspirate with Autogenous Bone graft for Alveolar Cleft in a new Rabbit Model)

  • 배성근;정호윤;이상윤;조병채;양정덕;박미영
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.531-537
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    • 2009
  • Purpose: Alveolar bone grafting has become an essential process in the treatmemt of alveolar cleft patient for stabilization of the maxillary arch, elimination of oronasal fistula, the reconstruction of the soft tissue nasal base support, and creation of bony support for tooth eruption for implant. The use of Autologous iliac cancellous bone is preferable because of the adequate quantity and high osteoinductive potential. However, even with iliac bone, insufficient osteoregeneration and absorption occur due to several factors such as the patient's age, cleft width, functional stress, and others. In order to increase osteoregeneration where the iliac bone is placed, the present study is associated with bone marrow aspirate (BMA). The experimental study evaluated the efficacy of osteoregeneration in normal cleft rabbits when alveolar bone grafting was performed with autologous iliac corticocancellous bone. Methods: Twenty - four New Zealand White rabbits were divided randomly into 2 groups (BMA, control). All animals underwent harvesting of corticocancellous bone graft from the right posterior iliac crest via standard surgical technique. $1m{\ell}$ of BMA were obtained by scraping the needle and aspirate with $10m{\ell}$ syringe from the contralateral iliac bone wall. The muco - periosteal flap on the palate was elevated. A mixture of Equal bone's volumes with BMA and saline as its control was inserted into the cleft. Animals were sacrificed at 2, 4, and 8 weeks and maxilla was harvested for dental peri - apical X-ray, bone matrix density (BMD),and histologic analysis. Result: BMD of regenerated bone to the cleft in the rabbits was higher than that of the control rabbits. X-ray, histologic analysis showed that increased osteoregeneration and low absorption rate were observed in the BMA group. Conclusion: Our experimental study showed BMA enhanced the osteoregeneration and survival rate of alveolar bone grafting. BMA is easy to extract & cost - time effective. So it can be an effective enhancers for bone grafting mixtures.

구강과 인후두의 악성종양 치료시 발생한 누공의 진단과 치료 (Diagnosis and Treatment of Pharyngocutaneous Fistula After Treatment of Oral Cavity and Pharyngolaryngeal Cancer)

  • 홍현준;송승용;이원재;유대현;나동균
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.611-616
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    • 2009
  • Purpose: The rate of fistulas occuring followed by resection of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer are reported to be 9 ~ 23% according to various documents. Neglected treatment of the fistula can result in a setback in proper treatment with restrictions in oral intake leading to delayed return to daily life. Furthurmore, in severe cases, it may injure important vessels and adjacent structures of the neck area. The author reviewed previously reported cases of treatment methods for fistulas recurring after diverse head and neck operations and with sharing the treatment experiments of our patients, we tried to present a treatment algorism for different fistula types. Methods: Our study was based on retrograde analysis of 64 patients who were clinically diagnosed with fistula after operation for cancer of the head and neck from 1997 to 2008 at Severance Hospital. Their primary sites of cancer were 8 oral cavity, 22 oropharynx, 25 hypopharynx, and 9 larynx. The patients were aged 45 to 75 years and the male to female ratio was 11 to 1. The patient's operation records and progress notes were evaluated for determination of degree of fistula and treatment methods. Results: Most fistulas were clinically suspected after postoperative 5 days and symptoms noted for detection of the fistula were erythema, purulent discharge, edema, tenderness, and fluctuation. The fistula was definitely diagnosed at postoperative 2 weeks with barium test and treatment method ranging from conservative management to operative procedure were applied to each patients. Total 21 patients were managed with conservative protocol. In 15 cases, direct repair of the fistula was done and more stable repair of the fistula was possible with using of TachoComb$^{(R)}$. Pharyngostoma was performed in 14 patients. Among them, 4 patients healed spontaneously, 5 patients were taken direct closure, 4 patients were taken pectoralis major musculocutaneous flap, and one patient was taken esophageal transfer. The other 14 patients were taken 11 pectoralis major musculocutaneous flaps and 3 free flaps without pharyngostoma formation. Conclusion: Fistula is a troublesome complication resulting after resection of head and neck cancer. Early detection and adequate treatment according to the period and condition of the fistula may prevent further complications and reduce the pain of the patient.

개의 어깨 관절에서 박리성 골연골염의 진단과 치료를 위한 탐색적 관절내시경의 적용 (Exploratory Arthroscopic Treatment to Diagnose and Treat Osteochondritis Dissecans of the Shoulder Joint in a Dog)

  • 김충섭;이해범;최을수
    • 한국임상수의학회지
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    • 제30권2호
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    • pp.146-149
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    • 2013
  • 6개월 된 수컷 Great Pyrenees (35 kg)가 왼쪽 앞다리에 2주 동안 지속된파행으로 전북동물의료센터에 내원하였다. 파행은 병원 내원 3일 전부터 더욱 심해졌다고 한다. 신체검사 상에서 환자는 왼쪽 어깨 부분에 통증을 보였고, 보행 검사에서 파행을 보이고 있었다. 방사선 검사와 신경계 신체검사에서는 유의적인 소견을 보이지 않았다. 의학적 기왕력과 보행검사를 토대로 박리성 골연골염을 의심하였다. 어깨관절에 대한 확실한 진단을 위해서, 탐색적 관절내시경 수술이 시행되었다. 미미한 두갈래근건초염과, 활막염, 그리고 상완골 머리 후내측에 위치한 박리성 골연골염 병변이 관찰되었다. 연골편의 제거, 연골하골의 변연절제가 관절내시경과 전기 버(electric burr)를 사용하여 실시되었다. 환자는 수술 다음 날에 퇴원하였다. 2주 후, 환자는 술 부를 핥아서 생긴 염증과 피하조직에 생긴 장액종으로 인해 내원하였다. 항생제 처치와 무균적 붕대가 적용되었고, 장액종은 수술적으로 제거되었으며, 관절내시경을 실시한 11주 후 환자의 보행은 정상이었다. 관절내시경은 관절낭 안쪽의 구조물 관찰이 가능하기 때문에 진단이 어려운 관절질환에 유용하게 사용될 수 있을 거라 사료된다.

韓國産 捕食線蟲(Mononchida: Nematoda)의 4 新種 기재 (Descriptions of Four New Species of Predatory Nematodes (Mononchida) From Korea)

  • 최영연;;이성민
    • 한국토양동물학회지
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    • 제4권2호
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    • pp.89-100
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    • 1999
  • 捕食線蟲目 (Mononchida)의 4신종을 기재하였다; Iotonchus obtusus sp. n.는 체장이 2.8 mm, a=33, b=4.2, c=61, V=68, 口腔은 61${\times}$45 ${\mu}$m이고, 背部齒는 基部에 있고, 陰門突起가 있으며, 꼬리는 짧고 반원형이며 末端部의 표피는 두꺼운 것이 특징이다. Miconchus valvapapillatum sp. n.는 體長이 2.7-3.6 mm, a=29-36, b=4.1-4.5, c=18.4-21, V=65-69, 口腔은 53-61${\times}$29-33 ${\mu}$m, 交接刺는 132-137 ${\mu}$m, 復中央補助突起는 28-31개이며, 陰門 前後方에 5-8개의 연속적인 돌기를 가지며, 3쌍의 陰門腺이 있다. Clarkus koreanus sp. n.는 體長이 1.1-1.3 mm, a=27.5-28.8, b=3.5-3.9, c=12-14.5, V=60-64, 口腔은 24-28${\times}$13.5-15 ${\mu}$m이고, 口脣部는 잘 區劃졌고, 雙器는 背部齒에 대해서 후방에 있으며, 陰脣을 가진다. Coomansus ulsani sp. n.는 體長이 1.2-1.5 mm이고, a=23.5-26, b=3.4-3.8, c=13.6-14.8, V=65-68, 口腔은 36-39${\times}$21-23 ${\mu}$m이고, 口脣部는 잘 區劃졌고 口腔壁은 1줄의 가는 세로 隆起部가 있다.

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한국고유종 각시붕어 Rhodeus uyekii 후각기관의 형태 및 조직, 세포화학적 특성 연구 (Morphology, Histology, and Histochemistry of the Olfactory Organ in Korean Endemic Fish, Rhodeus uyekii (Pices, Cyprinidae))

  • 김현태;윤승운;이용주;박종영
    • 한국어류학회지
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    • 제31권3호
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    • pp.123-130
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    • 2019
  • 한국 고유종 각시붕어 Rhodeus uyekii의 후각기관과 서식처의 물리 및 화학적 특성 그리고 생태적 습성과의 연관성을 알아보기 위해 실체현미경, 광학현미경, 주사전자현미경을 이용하여 해부 및 조직, 세포화학적 특성을 조사하였다. 후각기관의 외부형태는 반원의 전비공과 후비공, 비경계판으로 구성되는데, 특히 전비공의 앞쪽에는 아치형의 조직이 돌출되어 있다. 비강 내에는 14~15개의 후판으로 구성되는 로제트 구조를 보유하며 후판은 감각상피와 비감각상피로 구분된다. 감각상피는 후감각뉴런, 지지세포, 기저세포, 림프구, 형질세포로 구성되는 반면에 비감각세포는 층상상피세포, 점액세포, 비감각섬모세포, 미확인세포가 1종류 확인된다. 점액세포의 세포화학적 특성은 산성 및 중성의 황점액소(sulfomucine)로 나타났다.

Sensory change after implant surgery: related factors for recovery

  • Jung, Joon-Ho;Ko, Ji-Hoon;Ku, Jeong-Kui;Kim, Jae-Young;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권5호
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    • pp.297-302
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    • 2022
  • Objectives: This retrospective study aimed to analyze data on nerve damage in patients who complained of sensory changes after dental implant surgery, the clinical results according to proximity of the implant fixture to the inferior alveolar nerve (IAN) canal, and the factors affecting recovery of sensation. Materials and Methods: The electronic medical records of 64 patients who had experienced sensory change after implant surgery were reviewed. Patients were classified by sex, age, implant installation sites, recovery rate and the distance between the implant fixture and IAN canal on computed tomography (CT). The distance was classified into Group I (D>2 mm), Group II (2 mm≥D>0 mm), and Group III (D≤0 mm). Results: The 64 patients were included and the mean age was 57.3±7.3 years. Among the 36 patients who visited our clinic more than two times, 21 patients (58.3%) reported improvement in sensation, 13 patients (36.1%) had no change in sensation, and 2 patients (5.6%) reported worsening sensation. In Group II, symptom improvement was achieved in all patients regardless of the removal of the implant fixture. In Group III, 8 patients (40.0%) had reported symptom improvement with removal of the implant fixture, and 2 patients (33.3%) of recovered patients showed improvement without removal. Removal of the implant fixture in Group III did not result in any significant difference in recovery (P=0.337), although there was a higher possibility of improvement in sensation in removal cases. Conclusion: Clinicians first should consider removing the fixture when it directly invades the IAN canal. However, in cases of sensory change after dental implant surgery where the drill or implant fixture did not invade the IAN canal, other indirect factors such as flap elevation and damage due to anesthesia should be considered as causes of sensory change. Removal of the implant should be considered with caution in these situations.

경부청소술을 시행한 환자를 대상으로 한 경부청소술 후 장애지수에 대한 한글화 버전 표준화 (Validation of the Korean Version of the Neck Dissection Impairment Index in Patients Who Underwent Neck Dissection)

  • 임원섭;이창욱;이윤세;조민우;정영호;최승호;김상윤;남순열
    • 대한두경부종양학회지
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    • 제37권2호
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    • pp.43-50
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    • 2021
  • Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII. Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

Intrawound Vancomycin Powder Application for Preventing Surgical Site Infection Following Cranioplasty

  • Seong Bin Youn;Gyojun Hwang;Hyun-Gon Kim;Jae Seong Kang;Hyung Cheol Kim;Sung Han Oh;Mi-Kyung Kim;Bong Sub Chung;Jong Kook Rhim;Seung Hun Sheen
    • Journal of Korean Neurosurgical Society
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    • 제66권5호
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    • pp.536-542
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    • 2023
  • Objective : Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics. Methods : This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1 g) was applied on the dura mater and bone flap in 105 patients (18.1%; vancomycin powder group). Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within 1-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated. Results : Surgical site infection occurred in 31 patients (5.3%) and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4-333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105, 0.0%) was significantly lower than that in the conventional group (31/475, 6.5%; crude odds ratio [OR], 0.067; 95% confidence interval [CI], 0.006-0.762; adjusted OR, 0.068; 95% CI, 0.006-0.731; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. Conclusion : Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

화상센터에서 치료한 괴사성근막염의 임상적 고찰 (The Clinical Investigation of Necrotizing Fasciitis in Burn Center)

  • 김의명;전진우;김영민;윤재철;임해준;조용석;김도헌;허준;전욱
    • 대한화상학회지
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    • 제22권2호
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    • pp.66-70
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    • 2019
  • Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.