• Title/Summary/Keyword: Need for closure

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Reconstruction of alveolar bone defect in bilateral cleft lip and palate using bifocal distraction-compression osteosynthesis (양측성 구순구개열 환자의 치조골 결손부의 재건치료를 위한 distraction-compression osteosynthesis)

  • Lee Jin-Kyung;Baek Seung-Hak;Lee Jong-Ho
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.1
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    • pp.47-61
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    • 2004
  • The closure of a wide alveolar cleft and fistula in cleft patients and the reconstruction of a maxillary dentoalveolar defect in bilateral cleft lip and palate (BCLP) patients are challenging for both orthodontists and oromaxillofacial surgeons. It is due to the difficulty in achieving complete closure by using local attached gingiva (palatal flap) and the great volume of bone required for the graft. In this article, the authors used bifocal distraction-compression osteosynthesis(BDCO) to create a segment of new alveolar bone and attached gingiva for the complete approximation of a wide alveolar cleft/fistula and the reconstruction of a maxillary dentoalveolar defect. Since the alveoli and gingivae on both ends of the cleft were approximated after BDCO, the need for extensive alveolar bone grafting was eliminated. It also could create new alveolar bone and gingiva for orthodontic tooth movement and implant.

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Human Bites Over Nose: Management and Reconstruction

  • Kuldeep Singh;Krittika Aggarwal
    • Archives of Plastic Surgery
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    • v.50 no.2
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    • pp.171-176
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    • 2023
  • Background Human bite wounds in emergency department need evaluation in regard of reconstruction. These are due to occlusive bite injuries over face. Most commonly, human bites over face involve ear and nose, and may lead to avulsion injury. Defects over nose can be reconstructed immediately after debridement or delayed till the wound heals and scar becomes supple. Thorough wash and lavage with broadspectrum antibiotic cover has utmost importance in preventing cartilage infection. Methods We report 20 cases of human bite injuries over nose who presented to us in emergency department between 2018 and 2020. At the time of presentation the wound was assessed for closure. If not possible, patient was planned for delayed reconstruction after 3 months. In case delayed reconstruction was planned, the skin and nasal mucosa were approximated at first presentation. The patients underwent paramedian forehead flap after recreation of defect with conchal cartilage graft. Second stage of flap detachment and insetting was done after 3 weeks. After three weeks of second stage, third stage of flap thinning was done. Patients were followed for 3-6 months and subjective satisfaction was noted. Results Nineteen patients underwent delayed staged reconstruction with paramedian forehead flap and one underwent primary wound closure. The flap survival was 100%. The patient satisfaction was excellent in most cases. Conclusion We recommend delayed reconstruction for human bite nasal injuries. For reconstruction, paramedian forehead flap with conchal cartilage graft, if required, provides excellent reconstructive option with good contour and color match and minimal donor site scar.

Assessing the Willingness-to-Pay of a Scuba Diving Management in a Soft Coral Marine Protected Area (다이버를 대상으로 한 연산호(軟珊瑚) 서식 해양보호구역 다이빙 관리제도의 지불의사액 분석)

  • Kim, Miju;Oh, Chi-Ok;Nam, Jungho;Hong, Jong Ho
    • Ocean and Polar Research
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    • v.44 no.3
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    • pp.235-247
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    • 2022
  • A marine protected area (MPA) is a spatially designated section of the ocean where the biodiversity is high. Munseom MPA has a unique underwater landscape including soft coral, subtropical fish, and benthos, attracting many scuba divers. This paper intends to evaluate the willingness-to-pay (WTP) for the scuba diving management policy in the Munseom MPA. As a stated preference valuation method, a choice experiment was applied to assess divers' preferences with economic values for the policy. The attributes used in the study included zoning (temporal closure), conservation education, daily permit, soft coral area, and diving fee. We collected 333 questionnaires through online and field surveys and used 296 after excluding incomplete responses for the final data analysis. Study results show that a six-month closure, a decrease in soft coral habitat, and the diving fee were statistically significant. A positive coefficient with regard to the six-month closure variable indicates that divers preferred the policy, and the marginal willingness to pay (MWTP) was estimated to be KRW 8,637 per person per dive. The aggregate WTP of KRW 233 million was obtained by multiplying the MWTP by the number of visiting divers per year. When comparing the levels of recreation specialization, more skilled divers preferred the management option. The results of this study will help predict the priority of management measures and the levels of acceptability among divers when diving management is implemented in Korea in the future. This study suggests that marine environmental policies need to consider divers as one of the important stakeholders for marine conservation.

The efficacy and safety of transcatheter closure of atrial septal defect with Amplatzer septal occluder in young children less than 3 years of age (3세 미만 심방중격결손 소아에서 Amplatzer 기구 폐쇄술의 안전성 및 효용성)

  • Lee, Soo Hyun;Choi, Deok Young;Kim, Nam Kyun;Choi, Jae Young;Sul, Jun Hee
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.494-498
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    • 2009
  • Purpose : Applicability of transcatheter closure of atrial septal defect (ASD) has been expanded by accumulation of clinical experiences and evolutions of the device. This study was performed to evaluate the safety and efficacy of transcatheter closure of ASD with Amplatzer septal occluder (ASO) in young children less than 3 years of age. Methods : From May 2003 to December 2005, 295 patients underwent transcatheter closure of ASD with ASO in the Severance Cardiovascular Hospital, Yonsei University Health System. Among them, 51 patients less than 3 years of age were enrolled in this study. We investigated procedural success rate, rate of residual shunt, frequency of complications, procedure/fluoroscopy time, and need of modified techniques for device implantation. Results : The median age was 2.1 years and median body weight was 12 kg. Implantation of device was successful in 50 patients (98%). Seven patients (15%) showed a small residual shunt 1 day after the procedure, but complete occlusion had been documented at 6 month follow-up in all patients (100%). The pulmonary to systemic flow ratio (Qp/Qs), peak systolic pulmonary artery pressure, and peak systolic right ventricular pressure had decreased significantly after closure of ASD. There were 2 complications including device embolization (1, 2%) and temporary groin hematoma (1, 2%). Conclusion : Transcatheter closure of ASD with ASO can be performed with satisfactory results and acceptable risk even in young children less than 3 years of age. We could suggest that even in very young children with ASD, there is no need to wait until they grow to a sufficient size for the transcatheter closure.

A Study of Safety Evaluation Based on the Road closure Simulation, and on the Isolation Risk in Times of Disaster (재해시 위험가능성과 도로폐쇄시뮬레이션에 의한 방재안전성에 관한 연구 - 일본 오이타현 사이키시를 대상으로 -)

  • Kim, Daeill;Park, Sungchan;Go, Jooyeon;Yeom, Chunho
    • Journal of the Korean Society of Safety
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    • v.35 no.2
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    • pp.84-93
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    • 2020
  • In recent years, the scale of damage from disasters such as earthquakes and large-scale fires and floods that are occurring in Korea is increasing. Accordingly, interest in urban disaster prevention that combines living infrastructure such as roads and parks is boosting, and it is urgent to prepare measures to reduce the damage scale of local cities. The purpose of this study is to derive implications for disaster prevention measures in areas where disaster prevention safety of local cities is weak through examples of disaster prevention safety of local cities in case of disaster. To this end, this study analyzed the regional characteristics, current status, and disaster prevention problems of regional cities in Japan, and selected disaster-vulnerable areas, and considered the distance relationship between disaster prevention bases through road network analysis. In addition, road closure simulation using ArcGIS Network Analyst was conducted to analyze disaster prevention safety in the area. As a result, the situation of the village which has a high possibility of isolation by natural disasters was grasped in advance. Through this, the suburbs confirmed the necessity of supplementing the disaster prevention function through transportation maintenance such as forest roads, and it was found that the city needs to prepare a risk management system. Furthermore, this study suggests the need for research on areas with a high possibility of isolation, especially in areas where disaster prevention functions are weak in local cities in case of disaster, and shows countermeasures for disaster prevention measures and resident education.

Comparing intra-oral wound healing after alveoloplasty using silk sutures and n-butyl-2-cyanoacrylate

  • Suthar, Pratik;Shah, Sonal;Waknis, Pushkar;Limaye, Gandhali;Saha, Aditi;Sathe, Pranav
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.1
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    • pp.28-35
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    • 2020
  • Objectives: The need for proper wound closure is of paramount importance after any intra-oral surgery. Various wound closure techniques have been described in literature using traditional non-absorbable suture materials. These include like synthetic absorbable sutures, surgical staples and tissue adhesives. Cyanoacrylates are among the most commonly used biocompatible tissue adhesives. To evaluate and compare intraoral wound healing using 3-0 silk sutures and n-butyl-2-cyanoacrylate after alveoloplasty. Materials and Methods: A total of 20 patients requiring bilateral alveoloplasty in the same arch (upper or lower) were included in this study. Patients with any pre-existing pathology or systemic disease were excluded. After alveoloplasty was performed, the wound was closed using 3-0 braided silk sutures on one side, and using n-butyl-2-cyanoacrylate bio adhesive on the other side. Patients were evaluated based on the following parameters: time required to achieve wound closure; the incidence of immediate and postoperative hemostasis; the time to the use of the first rescue medication; the side where pain first arises; and the side where wound healing begins first. Results: Compared to 3-0 silk sutures, cyanoacrylate demonstrated better hemostatic properties, reduced operative time, reduced postoperative pain and better wound healing. Conclusion: These data suggest that cyanoacrylate glue is an adequate alternative to conventional sutures to close the surgical wound after alveoloplasty, and better than are 3-0 silk sutures.

Individualized ibuprofen treatment using serial B-type natriuretic peptide measurement for symptomatic patent ductus arteriosus in very preterm infants

  • Shin, Jeonghee;Lee, Eun Hee;Lee, Jee Hyun;Choi, Byung Min;Hong, Young Sook
    • Clinical and Experimental Pediatrics
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    • v.60 no.6
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    • pp.175-180
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    • 2017
  • Purpose: Plasma level of B-type natriuretic peptide (BNP), an emerging, sensitive, and specific biomarker of hemodynamically significant patent ductus arteriosus (PDA), rapidly decreases in infants receiving cyclooxygenase inhibitors for ductal closure. We investigated the usefulness of serial BNP measurement as a guide for individual identification of early constrictive responses to ibuprofen in preterm infants with symptomatic PDA (sPDA). Methods: Before March 2010, the standard course of pharmacological treatment was initiated with indomethacin (or ibuprofen) and routinely followed by 2 additional doses at intervals of 24 hours. After April 2010, individualized pharmacological treatment was used, starting with the first dose of ibuprofen and withholding additional ibuprofen doses if the BNP concentration was <600 pg/mL and clinical symptoms of PDA improved. Results: The BNP-guided group received significantly fewer doses of ibuprofen than the standard group did during the first course of treatment and the entire study period. The need for further doses of cyclooxygenase inhibitors and for surgical ligation was not significantly different between the 2 groups. No significant differences were seen in clinical outcomes and/or complications related to sPDA and/or pharmacological treatment. Conclusion: Individualized BNP-guided pharmacological treatment may be used clinically to avoid unnecessary doses of cyclooxygenase inhibitors without increasing the ductal closure failure and the short-term morbidity related to sPDA.

CLINICAL CASES OF NON-SURGICAL PALATAL EXPANSION ON ADULT PATIENTS

  • Kim, Kyung-Ho;Hong, Hee-Sook;Park, Jun-Ho
    • The korean journal of orthodontics
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    • v.25 no.6 s.53
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    • pp.733-746
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    • 1995
  • In narrow maxillary arch, midpalatal suture can be readily opened in growing children with maxillary palatal expansion. In adult patients, narrow maxilla is generally treated surgically because their growth are deemed completed due to their age. However, in patients under 25, midpalatal suture may not be closed. In addition, maxillary expansion may depend upon the closure of other maxillary sutures, which generally remain open at this stage. The present study attempted suture openings with palatal expansion on 5 female patients in their early 20's. The opening was successful in 4 patients, while only one patient showed no suture opening. In all 4 subjects, no discomfort or pain was present during s\expansion, and the successful suture opening was confirmed on occlusal x-rays. Therefore, for those patients with narrow maxilla in their early 20's, rapid palatal expansion or slow palatal expansion may offer a simple and less complicated option which, if successful, may preclude the need for surgery and thereby circumvent the psychological and financial burdens for the patients.

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A CASE REPORT ON THE SPACE MAINTAINER USING PRIMARY MOLAR HEMISECTION (유구치의 편측치아절제술을 이용한 공간유지장치)

  • Kim, Jun-Hyun;Lee, Jae-Ho;Kim, Seang-Oh;Shon, Heung-Ky
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.4
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    • pp.776-780
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    • 1997
  • Patient with alveolar abscess due to dental caries with severe alveolar bone loss, severe tooth mobility, root resorption need extraction of tooth because it is impossible to carry out pulp treatment and restoration by using conventional method. Early loss of primary molar might cause masticatory interference, extrusion of opposing tooth, problem in maintaining space and interference on eruption of permanent tooth. Especially, early loss of primary second molar before the eruption of permanent first molar might cause space closure by mesially erupted permanent first molar and impaction of second premolar. In such a case, distal shoe space maintainer and removable space regaining appliance was the first choice of treatment. But, distal shoe space maintainer need precise adaptation and might cause chronic inflammation if the oral hygiene is poor. In a case using removable space regaining appliance, patient's cooperation is most important. If the distal root of primary second molar is comparably sound and alveolar abscess with alveolar bone loss is localized at mesial root, hemisection should be carried out for precise guide to eruption of the permanent first molar, restoration of masticatory fuction and solution to the discomfort of the patient

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Landfill of Hazardous Wastes in Korea (국내 특정폐기물의 매립현황)

  • Lee, Dong-Soo
    • Applied Chemistry for Engineering
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    • v.3 no.2
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    • pp.213-223
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    • 1992
  • Although landfill has been heavily relied upon as a final hazardous waste disposal method in Korea, the legal and technical problems associated with the landfill severely hinder proper disposal of hazardous wastes. The single largest legal problem is simply that, in spite of the recent amendments, the law regulating the hazardous waste landfill is yet in its primitive stage that even the lawful landfill sites cannot be regarded safe. The technical problems include improper selection of landfill sites, poor design and construction of landfill facilities, and lack of QA/AC and post-closure cares. These technical problems stem from inexperience and lack of resources. For the reduction of the potential danger from the improper landfills of hazardous wastes, it is an immediate need to further refine the law and to resolve the technical problems.

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