• Title/Summary/Keyword: Outpatient surgery

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The Effect of the Impacted Position of Palatally Inverted Mesiodens on the Selection of Sedation Method

  • Soojin Choi;Jihyun Song
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.63-73
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    • 2023
  • Purpose: Hyperdontia is a developmental disorder of the oral cavity. Mesiodens refers to the hyperdontia located between the maxillary central incisors. During the surgical procedure, the anesthetic method for pain control should be considered along with factors related to the surgery itself. The purpose of this study was to evaluate the effect of the impacted position of the mesiodens on the selection of sedation method and to suggest incisive foramen as a brief reference. Materials and Methods: This study included 126 patients who were scheduled for extraction of mesiodens. The selection criteria included patients with one palatally impacted inverted mesiodens accessible from the palatal gingival margin, and those with good cooperation potential in order to control for clinical information. Using cone beam computed tomography, vertical, horizontal, and palatal positional factors were measured, and the anesthetic method was determined by two examiners. The patients were grouped into vertical and horizontal groups based on the position of the incisive foramen. Data were statistically analyzed using the Mann-Whitney test, the chi-square test, and logistic regression analysis. Result: All positional factors differed between the outpatient and inpatient anesthetic groups. The vertical minimum distance from the alveolar ridge to the mesiodens (Va) and the minimum distance from the palatal surface to the crown tip of the mesiodens (Tc) were factors affecting the choice of anesthetic method. The distribution of the vertical and horizontal positional groups differed between the outpatient and inpatient anesthetic groups. Conclusion: The incisive foramen can be used as a brief reference to determine the appropriate anesthetic method. Referral for inpatient anesthesia may be a priority if they are in the V2H2 group with Va ≥5 mm, and Tc ≥6 mm, and outpatient sedation may be considered if they are in the V1H1 group with Va ≤1.5 mm, and Tc ≤2.5 mm.

Stress Radiographs under Anesthesia for Painful Chronic Lateral Ankle Instability (동통을 동반한 족관절의 만성 외측 불안정성에 있어서 마취하 스트레스 방사선 검사)

  • Choi, Jun Young;Ahn, Hee Chan;Shin, Myung Jin;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.12-16
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    • 2017
  • Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

Outpatient Percutaneous Flexor Tenotomy for Diabetic Claw Toe Deformity with Ulcer (궤양을 동반한 당뇨성 갈퀴 족지에 대하여 외래에서 시행한 경피적 굴곡건 절단술)

  • Lee, Dong-Hun;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.151-155
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    • 2018
  • Purpose: Toe ulcers have been implicated as a causative factor in diabetic foot amputation. The aim of this study was to evaluate the outcomes of percutaneous needle flexor tenotomies of diabetic claw toes with ulcers or pending ulcers. Materials and Methods: The authors undertook a retrospective chart review between January 2014 and June 2016 to identify those patients who underwent a percutaneous needle flexor tenotomy for diabetic claw toe deformities. We evaluated 54 toes in 42 patients. Twenty-four patients were female and the mean age at the time of operation was 57 years. The mean follow-up time was 11 months. Thirty-four patients (46 toes) had tip toe ulcers or pending ulcers and 8 patients (8 toes) had dorsal pending ulcers. All patients had palpable pulses and good capillary refill. Results: Forty-three of 46 tip toe ulcers (93.5%) healed without significant complications and 8 dorsal ulcers showed no specific changes within 5 weeks. There were no recurrent ulcers at final follow-up. Four patients developed transfer lesion of the adjacent toe and needed subsequent tenotomy. Conclusion: Percutaneous needle tenotomy in an outpatient clinic was an effective and safe method for treating toe ulcers in neuropathic patients to offload the tip of the toe so that ulcer healing could occur.

congenital cystic adenomatoid malformation (C.C.A.M.)-Two cases report- (선천성 낭포성 선종양기형 (CCAM) -2예 보고-)

  • 이인성
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.352-357
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    • 1986
  • Congenital cystic adenomatoid malformation [CCAM] of the lung is a rare but often fatal congenital lung bud anomaly that causes acute respiratory distress in the newborn infants. In those who survive infancy and early childhood, its clinical manifestations are not unusual to detect. Recently we experienced two children with CCAM; one with coughing and high fever, another without any symptom On case I, the patient was a 9 year-old female, and was suffered from coughing and high fever since 15 days before. Medical treatment was failed and then, exploratory thoracotomy was performed under the impression of loculated empyema. Finally, a right lower lobectomy was done with a satisfactory postoperative course. On case II, the patient was a 12 year-old female, and admitted for evaluation of known large pulmonary cyst which was checked at the outpatient clinic. Preoperative evaluations gave no more informations, so obliteration of cysts was performed with open biopsy. Two patients with CCAM are described in Korean Univ. Medical Center.

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Differential Diagnosis of Chronic Coughing (만성 기침의 감별진단)

  • Do, Nam Yong;Park, Jun-Hee
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.87-90
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    • 2016
  • Cough, the most common symptom, encountered in the outpatient clinic can be caused by various underlying diseases. It defines as chronic cough that the duration of cough is more than 8 weeks with a normal chest X-ray findings. The cause of cough can be found out for more than 90% through the appropriate diagnostic approach and Upper airway cough syndrome, Asthma and Gastroesophageal reflex disease are the most common causes of disease to non-smokers. Chronic cough can be due to not one reason but various reasons and achieve good results by a systematic approach to diagnosis and a concrete treatment on the basis of the sufficient understanding of the underlying disease.

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Pulmonary Embolectomy for Acute massive Pulmonary Embolism - 1 case -

  • 이형교
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.804-810
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    • 1990
  • Pulmonary thromboembolism originated mostly from the venous thrombus, especially deep vein thrombosis in the lower extremities, which migrated upward and lodged the pulmonary vasculatures, Massive pulmonary thromboembolism usually leads to in \ulcornerhospital mortality if the patient was not treated properly. Under the cardiopulmonary bypass, a 49-year old man was treated successfully by emergent pulmonary embolectomy of pulmonary thromboembolism, which originated from the deep vein thrombosis in the right leg. Ligation or filtering device insertion of the inferior vena cava was not performed. The patient’s postoperative course was uneventful and discharged on postoperative 15th day He continued to receive oral anticoagulation with aspirin and persantin, which had been started on the third postoperative day. And he was well till recent days through the outpatient follow-up. The clinical courses of this patient are described, and massive pulmonary embolism and its management are discussed.

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A Case of Laryngeal Pleomorphic Adenoma (후두에 발생한 다형성 선종 1례)

  • Lee, Sang Hun;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.141-143
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    • 2017
  • Pleomorphic adenoma is the most common salivary gland neoplasm and most of them arise in the parotid gland. Pleomorphic adenomas at other sites than salivary glands have rarely been reported. We experienced a patient with pleomorphic adenoma of larynx. A 59 year-old female patient visited outpatient clinic complaining of voice change and foreign body sensation. Round mass at right vocal process was found in laryngoscopic exam. We performed laryngoscopic microsurgery to remove the tumor. Histologically, it was diagnosed as pleomorphic adenoma. Recurrence or complication did not occur during the follow up period of 3 years.

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A review of complications of maxillary sinus augmentation and available treatment methods

  • Kim, Joongmin;Jang, Hyonseok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.4
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    • pp.220-224
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    • 2019
  • Maxillary sinus grafting is a dependable procedure that has been in use for a long time. However, clinical complications often arise. To prevent complications of maxillary sinus grafting, it is necessary to know the contra-indications, both for general implantation and for maxillary bone grafting. In addition, presence of various complications requires careful consideration of treatment method; therefore, dentists should be familiar with the treatment protocols. Complications can be divided into postoperative, immediate postoperative, and delayed postoperative complications. Particularly for the outpatient, it is necessary to quickly distinguish between treatable cases and cases for which transfer is required. The purpose of this review is to discuss the contra-indications, complications, and treatment options for complications of maxillary sinus graft.

A Case of Unexpected Clinostomum complanatum Infection Initially Presenting as Foreign Body in Pharynx

  • Kim, Hyunjung;Cho, Sung-Weon;Oh, Harim;Byeon, Hyung Kwon
    • Parasites, Hosts and Diseases
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    • v.57 no.2
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    • pp.175-177
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    • 2019
  • A 46-year old man visited our outpatient clinic with complaint of foreign body sensation in throat after consuming raw freshwater fish 5 days ago. Laryngoscopic examination revealed a motile worm attached on posterior pharyngeal wall. The worm was removed using biopsy forceps under transnasal endoscopy and evidently identified as Clinostomum complanatum after microscopic examination. Patient's subjective foreign body sensation of throat and hyperemia of laryngeal mucosa remained for approximately 2 weeks post-removal, which were eventually resolved after administration of non-steroidal anti-inflammatory drug and anti-refluxant drug for 2 weeks. Treatment was ended at three weeks since the first visit. C. complanatum infections in humans are rare, and only four cases have been reported in Korea. Symptoms resembling pharyngitis or laryngitis occurs by consumption of raw, infected freshwater fish and treatment is done by mechanically removing the parasite.

Clinical Analysis of Radiocephalic Fistula Using Side-to-side Anastomosis with Distal Cephalic Vein Ligation

  • Hong, Sung Yong;Yoon, Young Chul;Cho, Kwang-Hyun;Lee, Yang-Haeng;Han, Il-Yong;Park, Kyung Taek;Ko, Seong-Min
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.439-443
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    • 2013
  • Background: The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. Methods: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. Results: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. Conclusion: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.