• Journal of Chest Surgery
• /
• v.19 no.1
• /
• pp.25-34
• /
• 1986

Recently, radionuclide angiocardiogram is one of the most common procedure for assessment of ventricular performance due to its distinctive advantages such as safety, accuracy, and ease of repeated studies. Also, measurement and comparison between pre and postoperative left ventricular ejection fraction [LVEF] are meaningful for assessing the severity of myocardial damage which occurred during open heart surgery and the status of myocardial recovery. We obtained pre and post operative LVEF using radionuclide angiocardiogram on 30 patients composed of atrial septal defect, ventricular septal defect, cyanotic congenital heart disease, and valvular heart disease who undergone the open heart surgery from March to august 1984. The study revealed that ventricular septal defect and mitral valvular heart disease showed 8.1% and 6.2% decreases of postoperative LVEF, respectively. But, there are little increases of postoperative LVEF in the atrial septal defect and cyanotic congenital heart disease. In ventricular septal defect, each group of Qp/Qs over 2.0 and systolic pulmonary artery pressure over 50mmHg showed significant 17% and 14.7% decreases of postoperative LVEF, respectively. Considering the duration of the aortic cross clamping times and closing methods of VSD, each group of duration over 30 min. and of patch closure showed 13.9% and 14.2% decreases of LVEF between pre and postoperative status respectively which was significant finding statistically.

• Journal of the Korean Society for Precision Engineering
• /
• v.21 no.6
• /
• pp.188-196
• /
• 2004

The objective of this paper is to propose a new technology of the orthopaedic surgery using the combination of reverse engineering (RE) based on CT data and rapid prototyping (RP). The proposed technology utilizes symmetrical characteristics of the human body and capability of the combination of RE and RP, which rapidly manufactures three-dimensional parts from CT data. The original .stl data of injured extents are generated from the mirror transformation of .stl file fur uninjured extents. The physical shape before injuring is manufactured from RP using the original .stl data. Subsequently, pre-operative planning, such as a selection of proper implants, preforming of the implant, a decision of fixation locations and an insert position for the implant, an estimation of the invasive size, and pre-education of operators are performed using the physical shape. In order to examine the applicability and the efficiency of the proposed surgical technology, various case studies, such as a distal tibia commented fracture, a proximal tibia plateau fracture and an iliac wing fracture of pelvis, are carried out. From the results of case studies, it has been shown that the proposed technology is an effective surgical tool of the orthopaedic surgery reducing the operational time, the operational cost, the radiation exposure of the patient and operators, and morbidity. In addition, the proposed technology could improve the accuracy of operation and the speed of rehabilitation.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.28.1-28.4
• /
• 2020

Background: This clinical case presented a novel method of segmental mandible reconstruction using 3D-printed titanium implant with pre-mounted dental implants that was planned to rehabilitate occlusion. Case presentation: A 53-year-old male who suffered osteoradionecrosis due to the radiation after squamous cell carcinoma resection. The 3D-printed titanium implant with pre-mounted dental implant fixtures was simulated and fabricated with selective laser melting method. The implant was successfully inserted, and the discontinuous mandible defect was rehabilitated without postoperative infection or foreign body reaction during follow-ups, until a year. Conclusions: The 3D-printed titanium implant would be the one of the suitable treatment modalities for mandible reconstruction considering all the aspect of mandibular functions.

• Journal of International Society for Simulation Surgery
• /
• v.3 no.1
• /
• pp.22-27
• /
• 2016

Background Craniosynostosis management using distraction osteogensis represent a challenge for surgeons due to the great variability of the skull deformity even within the same etiology. The ability to apply the simulation surgery for improving the preoperative planning for distraction osteogensis could improve the results.Planning and Simulation 14 patients presented with craniosynostosis had been subjected to simulation surgery prior to real surgery. 3D CT scans was obtained upon patient admission. Adjustment of all skull position to Frankfort horizontal plane was done. 3 different distraction osteogensis plans were done for each patient according to the skull morphology. For each plane, movement for each bone segment was done according to the pre-planned distraction vectors. Also the distances of distractions were pre-determined according to the cephalic index as well as brain volume. Intraoperatively, we choose the most appropriate plan for the patient by the surgeon. At the end of distraction, 3D CT scan was obtained, and was compared to the simulation plan. Also the distance and the direction of distraction was compared to that of the plan. Accordingly, the distance was almost matching that of the simulation surgery, however the vector of distraction was not matched.Conclusion Preoperative stimulation planning for craniosynostosis patient is very valuable tool in the surgical management of craniosynostosis patients.

• Journal of Chest Surgery
• /
• v.23 no.2
• /
• pp.236-244
• /
• 1990

To improve the prognosis of mitral valve replacement surgery, analysis and evaluation of pre and intra operative risk factors will be very much valuable. Author studied 205 cases of mitral valve replacement from Feb 1982 to June 1989 for the risk factors of hospital death. 90 patients were male and 115 were female, and age was from 16 to 59 years, Mitral stenosis dominant lesions were 91 cases and regurgitation 114. Suspected risk factors were NYHA functional class, cardiothoracic ratio, implanted valve type and size, operation time, age and sex, thrombus in left atrium, atrial fibrillation, aortic cross clamping time, left ventricular end diastolic and systolic dimension, nephropathy, hepatopathy and respiratory insufficiency. Statistic analysis was performed by X2 test between survivors and death group. Statistical significances as pre and intraoperative risk factors of hospital death after mitral valve replacement were confirmed in those presence of AF on the EKG, NYHA functional class[>IV], cardiothoracic ratio[>70%], and implanted valve size[>33mm]

• Korean Journal of Radiology
• /
• v.22 no.2
• /
• pp.189-197
• /
• 2021

Objective: Muscle depletion in patients undergoing liver transplantation affects the recipients' prognosis and therefore cannot be overlooked. We aimed to evaluate whether changes in muscle and fat mass during the preoperative period are associated with prognosis after deceased donor liver transplantation (DDLT). Materials and Methods: This study included 72 patients who underwent DDLT and serial computed tomography (CT) scans. Skeletal muscle index (SMI) and fat mass index (FMI) were calculated using the muscle and fat area in CT performed 1 year prior to surgery (1 yr Pre-LT), just before surgery (Pre-LT), and after transplantation (Post-LT). Simple aspects of serial changes in muscle and fat mass were analyzed during three measurement time points. The rate of preoperative changes in body composition parameters were calculated (preoperative ΔSMI [%] = [SMI at Pre-LT - SMI at 1 yr Pre-LT] / SMI at Pre-LT x 100; preoperative ΔFMI [%] = [FMI at Pre-LT - FMI at 1 yr Pre-LT] / FMI at Pre-LT x 100) and assessed for correlation with patient survival. Results: SMI significantly decreased during the preoperative period (mean preoperative ΔSMI, -13.04%, p < 0.001). In the multivariable analysis, preoperative ΔSMI (p = 0.016) and model for end-stage liver disease score (p = 0.011) were independent prognostic factors for overall survival. The mean survival time for patients with a threshold decrease in the preoperative ΔSMI (≤ -30%) was significantly shorter than for other patients (p = 0.007). Preoperative ΔFMI was not a prognostic factor but FMI increased during the postoperative period (p = 0.009) in all patients. Conclusion: A large reduction in preoperative SMI was significantly associated with reduced survival after DDLT. Therefore, changes in muscle mass during the preoperative period can be considered as a prognostic factor for survival after DDLT.

• The Journal of the Korean dental association
• /
• v.50 no.2
• /
• pp.58-63
• /
• 2012

The fundamental principles and the role of surgeons and orthodontists to produce successful results in orthodontic treatment combined with orthognathic surgery is not different from those of conventional procedures and FOS: surgery-first-orthodontic-treatment-later approach. The communication and cooperation between surgeon and orthodontist is of crucial importance. In FOS, the pre-surgical orthodontic preparation is not carried out in the patient's mouth, but in the mounted stone model and in addition to the simulation of tooth movement, to get a precise surgical occlusion, the entire steps of treatment should be simulated on the articulator as well. Right after the surgery, due to the instability of the occlusion, appropriate post operational care should be given according to the surgical technique applied to the mandible by use of final surgical wafer about 8 weeks.

• Journal of Cardiovascular Imaging
• /
• v.31 no.2
• /
• pp.98-104
• /
• 2023

BACKGROUND: We aimed to investigate left ventricular (LV) global longitudinal strain (GLS) in end-stage renal disease patients and its change after kidney transplantation (KT). METHODS: We retrospectively reviewed patients who underwent KT between 2007 and 2018 at two tertiary centers. We analyzed 488 patients (median age, 53 years; 58% male) who had obtained echocardiography both before and within 3 years after KT. Conventional echocardiography and LV GLS assessed by two-dimensional speckle-tracking echocardiography were comprehensively analyzed. Patients were classified into three groups according to the absolute value of pre-KT LV GLS (|LV GLS|). We compared longitudinal changes of cardiac structure and function according to pre-KT |LV GLS|. RESULTS: Correlation between pre-KT LV EF and |LV GLS| were statistically significant, but the constant was not high (r = 0.292, p < 0.001). |LV GLS| was widely distributed at corresponding LV EF, especially when the LV EF was > 50%. Patients with severely impaired pre-KT |LV GLS| had significantly larger LV dimension, LV mass index, left atrial volume index, and E/e' and lower LV EF, compared to mildly and moderately reduced pre-KT |LV GLS|. After KT, the LV EF, LV mass index, and |LV GLS| were significantly improved in three groups. Patients with severely impaired pre-KT |LV GLS| showed the most prominent improvement of LV EF and |LV GLS| after KT, compared to other groups. CONCLUSIONS: Improvements in LV structure and function after KT were observed in patients throughout the full spectrum of pre-KT |LV GLS|.

• Speech Sciences
• /
• v.14 no.3
• /
• pp.93-109
• /
• 2007

It is reported that the orthognathic patients suffer from not only aesthetic problems but also resonance disorder and articulation disorder because of the abnormality of the oral cavity. This study was designed to investigate the resonance of nasality and the intelligibility of speech for acoustic characteristics of patients' speech before and after orthognatic surgery. 8 orthognathic patients participated in the study. The nasality of words containing Korean consonants, Korean consonants and frequency and intensity of the fricative /s/ were measured using Nasometer and CSL (Computerized Speech Lab). Results were as follows: First, the nasality of post orthognathic surgery patients decreased in spontaneous speech. There was a significant difference in the nasality for all words between pre and post orthognatic surgery patients. Second, the nasality of each Korean consonant phoneme of post orthognathic surgery patients decreased. There was also a significant difference of the nasality for each Korean consonant phoneme between pre and post orthognatic surgery patients. Third, the decreased nasality for Korean consonant phonemes showed in plosives, affricates, fricatives, liquids, and nasals after surgery. But the significant difference showed only in plosives and fricatives. Finally, frequency and intensity for the fricative /s/ of post orthognathic patients increased.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.6
• /
• pp.443-450
• /
• 2022

Background: This double-blind randomized controlled trial (RCT) was conducted to evaluate the pre-emptive analgesia and anti-inflammatory efficacy of piroxicam compared with tramadol in patients undergoing oral surgery. Methods: Seventy-eight patients who required extraction of impacted mandibular third molars were randomized into three treatment groups of 26 patients each: group I received 100 mg of tramadol, group II received 20 mg of piroxicam, and group III received a placebo. Drugs were administered intramuscularly 30 min prior to the extraction procedure. Results: Pain intensity, time to first analgesic administration, total analgesic consumption, facial edema, and trismus were the outcomes of interest. The group receiving 20 mg of piroxicam showed significantly lower pain intensity, increased time to first analgesic, and reduced edema from preoperative to postoperative day seven than those in the tramadol and placebo groups. Conclusion: The findings of this study showed that piroxicam had significant pain relief efficacy after third molar surgery compared with that in tramadol.