• Title/Summary/Keyword: Malposition

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Can Right-Handed Surgeons Insert Upper Thoracic Pedicle Screws in much Comfortable Position? Right-Handedness Problem on the Left Side

  • Akyoldas, Goktug;Senturk, Salim;Yaman, Onur;Ozdemir, Nail;Acaroglu, Emre
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.568-573
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    • 2018
  • Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

The Criticality Analysis of Spent Fuel Pool with Consolidated Fuel in KNU 9 & 10 (조밀화 집합체로 중간저장하는 경우 원자력 발전소 9, 10호기의 사용 후 핵연료 저장조의 임계분석)

  • Jae, Moo-Sung;Park, Goon-Cherl;Chung, Chang-Hyun;Jang, Jong-Hwa
    • Nuclear Engineering and Technology
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    • v.20 no.1
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    • pp.27-34
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    • 1988
  • Since the lack of the spent fuel storage capcity has been expected for all Korean nuclear power plants in the mid-1990s, the maximum density rack (MDR) with consolidated fuels can be proposed to overcome the shortage of the storage capacity in KNU 9 & 10 which have most limited capacities. To ensure the safety when the alternatives are applied in the KNU 9 & 10, the multiplication factor are calculated with varying the rack pitch and the thickness of consolidated storage box by the AMPX-KENO IV codes. The computing system is verified by the benchmark calculation with criticality experiments for arrays of consolidated fuel modules, which was reported by B & W in 1981. Also an abnormal condition, i.e. malposition accident, is simulated. The results indicate that the KNU 9 & 10 storage pools with consolidated fuel are safe in the view of the criticality. Thus the storage capacity can be expanded from 9/3 cores into 27/3 cores even with considering equipments and cooling spaces.

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Esthetic restoration of malpositioned anterior teeth by tooth shape and gingival contour modification : a clinical report (위치이상 치아의 치은 성형을 동반한 심미적 보철수복)

  • Kim, Ja-Yeong;Kim, Kyoung-A;Seo, Jae-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.2
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    • pp.143-149
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    • 2015
  • In esthetic treatments, it is important to consider the arrangement of teeth and the relation between the teeth and soft tissues. A precise diagnosis and establishing an appropriate treatment plan is essential in an esthetic treatment of anterior maxillary teeth. For a fixed prosthesis to meet esthetic expectations, It is crucial to achieve symmetry and adequate proportions of the gingival contour around the crowns. To achieve an esthetic improvement and creating a favorable environment for gingival healing of a physiologic gingival contour, gingivectomy, crown lengthening and forced eruption can be applied to the appropriate site. All ceramics or porcelain laminate veneer can be selected for esthetic improvement of teeth contour and shade. In this case report, malposition of the remaining teeth made it hard to get an esthetic appearance. Gingivectomy, crown lengthening and provisional restoration insertion were performed before the final prosthesis fabrication to reform the gingival form. This case presents satisfying result esthetically and functionally.

Surgical Repair of Pectus Excavatum (누두흉의 수술적 교정)

  • 조덕곤
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.1027-1034
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    • 1990
  • Pectus excavatum, commonest developmental anomaly of chest wall, is manifested by depression of the sternum and lower costal cartilages that is of surgical interest. From 1982 through 1990, fifteen patients have undergone surgery for treatment of pectus excavatum and treated by Ravitch operation: 5, Modified Ravitch operation; 4, Wada operation, 1 and Modified Wada operation, 5. There was familial history of pectus excavatum in 3 patients. Associated congenital anomaly were seen in 6 patients; scoliosis in 3 patients, right inguinal hernia in 1, polydactyly in 1 and patent ductus arteriosus in 1 patent. Postoperative minor complications were developed in 3 cases; pneumothorax, 2 cases; pleural effusion, 2 cases; wound infection and dehiscence, 1 cases; pressure sore due to strut malposition, 2 cases; flail chest and 2 cases; seroma. The incidence of the postoperative complications were more common in cases who were treated by metal strut, pin or other prosthetic materials for supporting the chest wall integrity than the standard corrective procedure. All cases have no recurrence of chest wall depression and operative death.

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Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

  • Kim, Dongmin;Lim, Seong-Hoon;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.223-225
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    • 2013
  • Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

A Diagnostic Imaging Case of Cervical Spinal Subluxation for Chuna Mannual Therapy: Cervical Malposition with OPLL

  • Na, Hyun-Jong;Chang, Seok-Gon
    • The Journal of Korean Medicine
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    • v.37 no.4
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    • pp.45-48
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    • 2016
  • Objectives: A diagnostic imaging in a fifty five year-old woman diagnosed orthopedically as ossification of posterior longitudinal ligament (OPLL) at C5 and C6 levels was reinterpreted for Chuna mannual therapy. The cervical spinal lesion in simple X-ray and CT scan images was discussed by spinal listing systems and disc block subluxation theory. The primary adjustive target was C4 disc block subluxation, which had been affected by kyphosis. Chuna manual therapy based on diagnostic images could be helpful for adjusting spinal subluxation, correcting its adaptation curvature, and preventing its latent pathology efficiently.

Familial gigantiform cementoma (가족성 거대 백악종)

  • Han Won-Jeong;Kim Eun-Kyung
    • Imaging Science in Dentistry
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    • v.36 no.3
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    • pp.157-162
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    • 2006
  • Familial gigantiform cementoma is a rare fibre-cemento-osseous disease of the jaws which appears to be transmitted as an autosomal dominant trait with variable expressivity of the phenotype. A 7-year-old girl visited DKUDH complaining of the painless facial deformity. Clinically, significant facio-lingual expansion was observed at the left maxilla, left mandibular body and symphysis portion. Malposition of lower anterior teeth was found. Panoramic radiograph and CT scan showed the extensive expansile mixed lesion at maxilla and mandible. Bone scan revealed hot spot at the maxilla and left side of mandible. Histologic examination revealed moderately dense fibrous connective tissue with scattered masses resembling cementum. The patient's mother had a history of the mandibular resection due to benign tumor. Her younger brother had buccal expansion of right mandible. We report our finding of a family that has exhibited clinical, radiographic and histologic findings consistent with the familial gigantiform cementoma.

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Preduodenal Portal Vein Associated with Duodenal Obstruction -A case report- (십이지장 폐색을 동반한 십이지장 전방문맥 1례)

  • Huh, Young-Soo;Kim, Jae-Hwang;Suh, Bo-Yang;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.211-214
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    • 1990
  • Portal vein anomalies include absence, duplication, and malposition(preduodenal portal vein). Duplication of the portal vein or a preduodenal portal vein are hazards at the time of biliary or duodenal surgery. or liver transplantation. Preduodenal portal vein, which was first reported by knight in 1921, is extremely rare congenital anomaly and may cause duodenal obstruction. Recently, we experienced a case of preduodenal portal vein associated with dextrocardia, situs inversus, and duodenal obstruction in a 3 days old male newborn and report with review of the references.

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Technique Tip: A Simple Method to Treat Hallux Valgus with Severe Metatarsus Adductus (큰 중족골 내전각을 가지는 무지외반증에 대한 간단한 교정 방법)

  • Park, Chul Hyun;Choi, Young Hwa;Park, JeongJin
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.2
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    • pp.78-81
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    • 2019
  • Hallux valgus with metatarsus adductus is difficult to treat and has a higher risk of recurrence after correction. Some treatments for hallux valgus with metatarsus adductus have been reported, but these are extensive procedures with a risk of complications associated with the shortening and malposition of the lesser metatarsals. The technique described here is easier to perform and has several advantages over the previously reported techniques.

Case Report of a Patient Who Experienced Symptomatic Improvement Using Combined TMJ Balancing Therapy to Chronic Patellofemoral Pain (만성 슬개대퇴통증 환자에 턱관절균형요법을 병용하여 증상 개선을 보인 치험 1례)

  • Gawon Choe
    • Journal of TMJ Balancing Medicine
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    • v.13 no.1
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    • pp.27-31
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    • 2023
  • The purpose of this case report is to introduce a case of immediate results with TMJ balancing therapy (TBT) in the treatment of chronic patellofemoral pain (PFP). A 17-year-old female patient with 4-month-old chronic knee pain that was unresponsive to conventional treatment was treated with TBT for a total of 5 sessions. The primary outcomes were evaluated using the Numeric Rating Scale (NRS) and the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC). Following the first treatment, the NRS decreased rapidly, and the KWOMAC improved after a total of five treatments. These findings suggest that TBT can be an effective pain management option for chronic PFP patients with temporomandibular joint malposition. However, as this study is a report of a single case, further research is necessary.

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