• Title/Summary/Keyword: Open debridement

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Laser therapy in dentinal hypersensitivity and periodontal treatment (상아질 지각과민증과 치주 처치에서 레이저의 이용)

  • Namgung, Cheol;Lee, Jong-Ho;Kum, Kee-Yeon;Lim, Young-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.4
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    • pp.307-314
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    • 2014
  • Although a laser has been introduced to implant dentistry for decades, its efficacy is still open debate. The aim of this literature review is to analyze and evaluate the efficacy of laser therapy for the treatment of dentinal hypersensitivity and periodontal conditions.

Partial thickness tear: Debris vs. Repair (회전근 개 부전층 파열: 변연절제술가 봉합술)

  • Oh, Jeong-Hwan;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.34-39
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    • 2005
  • Partial thickness rotator cuff tears (PTRCTs) are now a well-established clinical entity, yrt there is no consensus in regards to surgical management. Recommended treatment varies widely from simple debridement of the torn tendon to subacromial decompression to excision of the degenerative tendon and repair. Surgery may be performed using an open, arthroscopically assisted (miniopen), or entirely arthroscopic procedure. The advantages and disadvantages of open and arthroscopic procedures may lie in the balance between precision and morbidity. Visualization of both the articular and bursal surfaces is mandatory to determine the level of rotator cuff disease and formulate a treatment strategy. Because these tear often are secondary finding, recognition of the primary pathology is critical. Treatment of the primary problem usually remedies the partial tear. However, when there is significant PTRCT, an arthroscopic or open repair of the diseased tendon will give the most consistent results.

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Video-Assisted Thoracoscopic Surgery for Fibrinopurulent Empyema (섬유농성 농흉의 비디오 흉강경을 이용한 치료)

  • 손정환;모은경;지현근;김응중;신호승;신윤철
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.404-410
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    • 2003
  • Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.

Medial impingement syndrome of the ankle associated with large anteromedial osteophyte of talus - A case report - (거골의 전내측에 큰 골극이 동반된 족관절의 내측 충돌증후군)

  • Yu, Sun-O;Kim, Jong-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.124-128
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    • 2002
  • After a severe ankle sprain, the incidence of residual complaints, particularly on the medial side of the joint, is high. We experienced a case of medial impingement between medial malleolus and anteromedial osteophyte of talus, specially in the dorsiflexion of the right ankle. Twenty five-year-old male was complained tenderness and chronic pain over the medial side of the right anklel for 3 years after an inversion sprain of the ankle. The plain radiography revealed a bony osteophyte on the anteromedial side of talus. The patient was treated by the open arthrotomy of the ankle. At surgery, impingement between articular surface of medial malleolus and osteophyte of the talus was observed when ankle dorsiflexion was done. Chondral lesion of medial malleolus and chondromalacic degeneration on anteromedial talus was viewed. Surgical removal of osteophyte on talus and debridement and multiple drilling of chondral lesion on medial malleolus was done. The symptom was improved. After postoperative 1 year, recurrence was not.

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Salvage of an exposed cranial prosthetic implant using a transposition flap with an indwelling antibiotic irrigation system

  • Hwang, Sung Oh;Chang, Lan Sook
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.73-76
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    • 2020
  • Cranial implant removal is recommended if implants become exposed owing to scalp necrosis after cranioplasty. However, it carries the risk of extensive bleeding, and the resultant cranial defects can cause both aesthetic and functional problems. We present a case of a scalp defect exposing a cranial prosthetic implant that was reconstructed with a local flap and salvaged using an indwelling antibiotic irrigation system. A 73-year-old man presented with scalp necrosis after undergoing cranioplasty due to intracranial hemorrhage. The cranial implant was exposed through the scalp defect. Methicillin-resistant Staphylococcus aureus was detected in the culture from the open wound. After debridement of the necrotic tissue and burring of the superficial layer of the implant, a transposition flap was used to cover the defect and an indwelling antibiotic irrigation system was installed. Continuous irrigation with vancomycin was conducted for 5 days, and intravenous vancomycin was continued for 4 weeks. The flap was in good condition at 4 months postoperatively, with no infection. The convex contour of the scalp was well maintained. The patient's neurological status was stable. Exposed cranial implants can be salvaged with continuous antibiotic irrigation as an alternative to implant removal; thus, the risk of bleeding and possible disfigurement may be avoided.

Arthroscopic rotator cuff surgery without traction system in the lateral position (측와위에서 견인 기구 없이 시행하는 견관절경하 회전근 개 수술)

  • Moon, Young-Lae;Jung, Heuk-Jun
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.50-54
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    • 2003
  • Object: To evaluate the efficiencies of the arthroscopic rotator cuff surgery which is Performed without the traction system in the lateral decubitus position. Methods: Twenty-nine cases of the arthroscopic rotator cuff surgery performed without the traction system in the lateral decubitus position were studied from February, 2002 to January, 2005. We performed a repair using the arthroscopic debridement and the arthroscopic rotator cuff repair, or using the mini-open incision technique after the confirmation of rotator cuff tear, then, the arthroscopic subacromial decompression was performed after the confirmation of subacromial lesions Results: We could easily find the subscapularis tear which was often overlooked in the arthroscopic rotator cuff surgery performed with the traction surgery by the relaxation of the subscapularis, as the arm position was internally rotate about 45 to 70 degrees from abducted position. We found that the operation time was reduced 14 minutes shorter than the operation time of the controlled group which had the surgery with the traction system on the average. We also found that there were no neurovascular complications from all cases. Conclusions: The arthroscopic rotator cuff surgery without traction system in the lateral decubitus position provided the better visual field, easy manipulation of the joint and reducing operation time.

Treatment of Freiberg Disease with Metatarsophalangeal Arthroscopy - A Case Report- (중족지 관절경을 이용한 Freiberg 병의 치료 -1예 보고-)

  • Ahn, Jae-Hoon;Lee, Seung-Hun;Lee, Kwang-Won;Choy, Won-Sik;Kam, Byoung-Sup
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.59-62
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    • 2007
  • Freiberg disease is a relatively rare osteochondrosis of metatarsal head, which usually involves the 2nd metatarsal of adolescent females. Various open surgical treatments have been recommended; arthrotomy and removal of loose body, dorsiflexion osteotomy and resection of the metatarsal head. Arthroscopic treatment for Freiberg disease has a merit of shortening the recovery period and reducing the postoperative stiffness. We report a case of early stage Freiberg disease treated with metatarsophalangeal arthroscopic excision of loose body and debridement of the 2nd metatarsophalangeal joint.

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REPORT OF THE MANAGEMENT OF GUNSHOT WOUNDS TO THE LEFT FACE (산탄총에 의한 좌측 안면부 손상 환자의 치험례 (증례보고))

  • Kim, Il-Kyu;Lee, Sang-Sun;Oh, Sung-Sup;Choi, Jin-Ho;Kim, Hyung-Don;Oh, Nam-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.224-227
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    • 2000
  • Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

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Post-Traumatic Big Toe Reconstruction using Anterolateral Thigh Free Flap: A Case Report (전외측 대퇴 유리피판을 이용한 외상 후 족무지 재건: 증례 보고)

  • Wang, Jae-Kwon;Eun, Seok-Chan;Baek, Rong-Min
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.457-460
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    • 2010
  • Purpose: The great toe presents a reconstructive challenge for plastic surgeons. The big toe has much importance not only for the gait and the stability, but also for appearance aspects. Few reports have documented the reconstruction of big toe defects and we report a unique case of free flap reconstruction technique. Methods: A 41-year-old man with right great toe open fracture with soft tissue necrosis was referred from the orthopedic surgery department. On physical examination, there was the skin necrosis circumferentially and the fratured bone was severely fragmented. The metatarsophalangeal (MTP) joint of the big toe was intact. After the wound debridement, we harvested the innervated anterolateral thigh flap and transposed to the defected area. After five months, we finally retouched the flap by the dorsal defatting and distal debulking. Results: He had an uneventful postoperative course without infection, dehiscence and flap necrosis. He has remained asymptomatic for eight months without any recurrence such as the osteomyelitis. Finally, he kept the normal gait and posture with weight bearing on the reconstructed great toe and foot. Conclusion: The anterolateral thigh flap is described for the reconstruction of the great toe. It involves two stage procedure with the minimal donor site morbidity and provides a good cosmetic result.

Aortic Periannular Abscess Invading into the Central Fibrous Body, Mitral Valve, and Tricuspid Valve

  • Oh, Hyun Kong;Kim, Nan Yeol;Kang, Min-Woong;Kang, Shin Kwang;Yu, Jae Hyeon;Lim, Seung Pyung;Choi, Jae Sung;Na, Myung Hoon
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.283-286
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    • 2014
  • A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechanical aortic valve by using a leaflet of the half-folded elliptical bovine pericardial patch. Another leaflet of this patch was used for the repair of the right atrial wall with a defect and the TV.