• Title/Summary/Keyword: Prostheses, Infection

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The Use of Nylon Tube as Aortic Prostheses: 2 Cases (Nylon tube를 이용한 대동맥 Prostheses (2례))

  • 윤윤호;정영환;김근호
    • Journal of Chest Surgery
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    • v.3 no.1
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    • pp.47-54
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    • 1970
  • This is a report on two cases of aortic prostheses using Nylon tube. (Edwards-Tapp A-G Tube, Chemically treated braided Nylon arterial grafts). Especially, the complications after infection of synthetic graft are discussed with reviewing literature. First case was the patient who came to our hospital with rupture of the right femoral artery at the femoral fossa due to pyogenic necrotic process. After femoral arterial prostheses, good pulsation of dorsal artery of foot was obtained. However, the tube was obstructed after 8 weeks postoperatively due tll the complication of infection. In spite of the tube was removed because of obstruction and foreign body reaction of synthetic graft, an amputation of the leg was not necessary for formation of good collateral circulation. Second case was a case of aortic aneurysmal rupture in thoraco-abdominal junction which developed by the trauma of rib resection for osteomyelitis of the left 12th. rib An implantation of aortic graft was performed at the lowest tho13cic aorta by the way of thoraco-abdominal bypass without arterial pump. However, infection produced pyothorax in the left pleural cavity, exposing the tube within the pyothorax. The rupture of the anastomosed upper line occurred in 8 weeks postoperatively and the patient expired.

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Removal of Infected Transvenous Pacemaker Electrode -2 cases- (감염된 경정맥 심박조절기의 치료 -2례 보고-)

  • 조은희
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.404-408
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    • 1995
  • Infection, although uncommon, can be the most lethal of all potential complication after transvenous pacemaker implantation. When infection is present, removal of the electrode is the only successful means of therapy. The entrapped electrode can be removed by continuous traction, by use of endoscopic forceps and snares, and by operation. We report 2 cases of removal of infected transvenous pacemaker successfully. In one case of staphylococcus aureus endocarditis associated with a retained pacemaker electrode, the electrode was removed by hand traction. The other case of skin infection of generator pocket, the electrode removed by orthopedic pulley system. Consequently, we recommended removal of all hardware if there is infection of the pacemaker system.

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$^{99m}Tc$-HMPAO-labelled Leucocyte Scintigraphy in the Diagnosis of Infection after Total Knee Replacement Arthroplasty (인공슬관절 전치환술 환자에서 $^{99m}Tc$-HMPAO-백혈구 스캔을 이용한 인공관절 감염의 진단)

  • Park, Dong-Rib;Kim, Jae-Seung;Ryu, Jin-Sook;Moon, Dae-Hyuk;Bin, Seong-Il;Cho, Woo-Shin;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.413-421
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    • 1999
  • Purpose: This study was performed to evaluate the usefulness of $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy Materials and Methods: The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age. 65 years) who had total knee replacement arthroplasty. After injection of $^{99m}Tc$-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection. Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. Results: Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positives, one false positive and three true negatives in Group B, and six true negatives and two false positives in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively Conclusion: $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity.

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Oral mucormycosis in an 18-month-old child: a rare case report with a literature review

  • Kalaskar, Ritesh Rambharos;Kalaskar, Ashita Ritesh;Ganvir, Sindhu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.2
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    • pp.105-110
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    • 2016
  • Oral mucormycosis is a fungal infection observed mainly in elderly immunocompromised patients. In rare instances, the disease occurs in healthy individuals and those patients that are below preschool age. Although this condition mainly involves the maxilla, it may also manifest in any part of the oral cavity based on the source of infection. Mucormycosis of the maxilla spreads rapidly, leading to necrosis of the palatal bone and palatal perforation. Such patients are usually rehabilitated using bone grafting or free flap surgeries. However, when surgeries are delayed, palatal prosthesis is an interim treatment modality that can prevent nasal regurgitation and aspiration of food or fluids. Palatal prostheses also help with mastication, speech, and swallowing. The present case describes a rare case of oral mucormycosis in an 18-month-old male involving the maxilla that was managed by palatal prosthesis.

Late Complication of a Silicone Implant Thirty Years after Orbital Fracture Reconstruction

  • Lee, Chi An;Kang, Seok Joo;Yun, Ji Young;Sun, Hook
    • Archives of Craniofacial Surgery
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    • v.18 no.2
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    • pp.137-140
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    • 2017
  • Alloplastic materials used for orbital fracture reconstruction can induce complications, such as infection, migration, extrusion, intraorbital hemorrhage, and residual diplopia. Silicone is one of the alloplastic materials that has been widely used for decades. The author reports a rare case of spontaneous extrusion of a silicone implant that was used for orbital fracture reconstruction 30 years earlier. A 50-year-old man was admitted to the emergency room for an exposed substance in the lower eyelid area of the left eye, which began as a palpable hard nodule a week earlier. The exposed material was considered to be implant used for previous surgery. Under general anesthesia, the implant and parts of the fibrous capsule tissue were removed. Several factors hinder the diagnosis of implant extrusions that occur a long period after the surgery. So, surgeons must be aware that complications with implants can still arise several decades following orbital fracture reconstruction, even without specific causes.

Development of Cannula-typed Silicone Voice Prosthesis(So-Mang$\circledR$) (Cannula-typed Silicone Voice Prosthesis(소망$\circledR$)의 개발)

  • 최홍식;정은주;전희선;문인석;김영호;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.12 no.2
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    • pp.152-157
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    • 2001
  • Background : Electrolarynx, Esophageal voice, and Silicone voice prosthesis with tracheoesophageal(T-E) fistula have been used as vocal rehabilitating methods for the post-laryngectomized patients. Prosthetic rehabilitation of voice after total laryngectomy has gained wide acceptance and has become a common practice in many clinics since the pioneering works of Singer and Blom In 1979. Since the introduction of tracheo-esophageal puncture and application of Blom Singer$\circledR$ voice prosthesis in 1980, several reliable voice prostheses have been developed and are successfully being used. Objectives : Even though quality of voice produced by Silicone voice prosthesis with T-E fistula is superior to other modalities, it still has some disadvantages. We devised a new cannulatyped silicone voice prosthesis. Methods : 1) Devising a new prototype of cannula-typed silicone voice prosthesis. 2) Application of the prototype using canine animal model(laryngectormized dog) and fitting trial on human patient whose previously inserted Silicone voice prosthesis is not functioning due to presumed fungal infection. Discussion : Final form of prototype was made after several times of major and minor modifications. Insertion of the newly developed Cannula-typed Silicone voice prosthesis on canine animal model and human trial were done without any difficulty. There were no serious leakage of saliva or food during swallowing. Conclusion : The newly developed Cannula-typed Silicone voice prosthesis(So-Mang$\circledR$) and the modified replacement method will further improve the results of post-laryngectomized prosthetic voice rehabilitation. Long-term animal study and human trial are planned in the near future.

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Emerging and Established Global Life-Style Risk Factors for Cancer of the Upper Aero-Digestive Tract

  • Gupta, Bhawna;Johnson, Newell W.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.5983-5991
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    • 2014
  • Introduction: Upper aero-digestive tract cancer is a multidimensional problem, international trends showing complex rises and falls in incidence and mortality across the globe, with variation across different cultural and socio-economic groups. This paper seeks some explanations and identifies some research and policy needs. Methodological Approach: The literature illustrates the multifactorial nature of carcinogenesis. At the cellular level, it is viewed as a multistep process involving multiple mutations and selection for cells with progressively increasing capacity for proliferation, survival, invasion, and metastasis. Established and emerging risk factors, in addition to changes in incidence and prevalence of cancers of the upper aero-digestive tract, were identified. Risk Factors: Exposure to tobacco and alcohol, as well as diets inadequate in fresh fruits and vegetables, remain the major risk factors, with persistent infection by particular so-called "high risk" genotypes of human papillomavirus increasingly recognised as also playing an important role in a subset of cases, particularly for the oropharynx. Chronic trauma to oral mucosa from poor restorations and prostheses, in addition to poor oral hygiene with a consequent heavy microbial load in the mouth, are also emerging as significant risk factors. Conclusions: Understanding and quantifying the impact of individual risk factors for these cancers is vital for health decision-making, planning and prevention. National policies and programmes should be designed and implemented to control exposure to environmental risks, by legislation if necessary, and to raise awareness so that people are provided with the information and support they need to adopt healthy lifestyles.

Saddle Prosthesis (안장형 인공 고관절 전치환술)

  • Park, I.H.;Ihn, J.C.;Lee, J.M.
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.133-144
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    • 1995
  • After resection of intraarticular, periacetabulum(P2) and pubic rami(P23) and extraarticular, proximal femur(P2-H12) by Enneking classification, reconstruction is very difficult. We experienced three cases of saddle prostheses for reconstruction after P2, P23, and P2-H12 resection in pelvic malignancies. Case 1 was a high grade chondrosarcoma in 36 year-old-man and P2 resection was done. But he died of disease 19 months after operation. Case 2 was a malignant giant cell tumor in 32 year-old-woman. P23 resection was given and she is disease-free 32 months after operation. Case 3 was an osteosarcoma of 27-year-old-man and P2-H12 resection was performed and he is disease-free postoperative 12 months now. According to MSTS functional evaluatin system, all three patients showed no pain(5), intermediate function(2), emotinally satisfied(3), one cane or crutch supported(1), limited walking(3), and minor cosmetic gait(3). There was no significant complication and no dislocation except intermittent inguinal hernia in case 2. All patients started crutch walking 3 weeks after operation. Around 6 months postoperatively, the preserved iliac wing(P1 component) was hypertrophied enough to endure the full weight bearing. All could have squating and kneeling positions. In conclusion, saddle prosthesis would be a very useful method of reconstruction after P2, P23, and/or H1-2 resection to shorten the operation time and to reduce the infection rate without significant loss of function.

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Success and survival rate of the implant with crestal sinus lift using S-reamer and gel-type graft material: A retrospective study by more 5-years follow check up (S-reamer와 겔 형태의 이식재를 이용한 치조정 접근법을 통한 상악동 거상술 임플란트의 성공률과 생존율: 5년 이상 추적 관찰을 통한 후향적 연구)

  • Kim, Jong Jin;Cho, Sung Am
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.1
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    • pp.23-29
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    • 2020
  • Purpose: The purpose of this retrospective study was to evaluate the method using the S-reamer and gel-type graft material by the success rate and survival rate. Materials and methods: Implantation period was from 2008 to 2014, Follow check up year is 2019. There were 59 patients and 117 implants. All implants were placed in the posterior maxilla with the sinus lift. The patients population consisted of 34 men and 25 women, ranging from 19 to 75 years. The residual bone heights were from 1 mm to 6 mm. Sinus was perforated with S-reamer without membrane tearing and gel type bone graft material was used for membrane lifting and filling the space. all implants were placed simultaneously. Panoramic X-ray was taken. After 5 - 6 months healing period, final prostheses were restored. After more 5-years implant surgery, Panoramic X-ray was obtained and X-ray analysis and clinical examination were performed. Success criteria was referred to a Buser's success critera. All implants were classified to success implant, survival implant, failed implant. A success implant was satisfying success criteria, a survival implant was a implant that was acute infection with suppuration and bone loss, a failed implant was a implant that was mobile, removed. Results: Five implants were removed, and 4 implants had infected with bone loss. Survival rate was 95.7% and success rate was 92.3%. Conclusion: This retrospective study presented that this method with S-reamer and gel-type graft material was a successful treatment without membrane tear in the condition of 1-6 mm residual bone height.

Do the Rotating Hinge-Flexible Intramedullary Nail Composites Alleviate Junctional Osteolysis in Megaprothesis Reconstruction for Bone Tumor? (탄력성 있는 골수강 내고정물과 회전경첩형 슬관절 전치환물을 조합한 종양인공관절로 자가골의 골 용해를 감소시킬 수 있는가?)

  • Song, Won-Seok;Cho, Wan-Hyeong;Cho, Sang-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.96-104
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    • 2007
  • Purpose: The authors investigated whether 35 flexible nail-rotating hinge composite reconstructions around knee joint minimize junctional osteolysis of host bone. Material and Method: The reconstructive technique was as follows: 1) en bloc tumor resection, 2) filling of the host bone marrow cavity with multiple Ender nails, 3) assembling the Ender nails and an Endo-Link type total knee component with wire and bone cement. Result: Mean follow-up was 53 months (ranged 30~79). At final follow-up, 29 patients retained a mobile joint. Resection of more than 40% of bone showed a positive relationship with junctional hypertrophy (p=0.028). Eight patients showed nail breakage and eight prostheses were removed due to early or late infection. The cumulative prosthetic survival rate was 33% at 6 year. Average functional score according to the MSTS criteria was 26.8. Conclusion: Mid-term evaluations showed that results were fair. The revision process was straightforward. Junctional hypertrophy observed appears to give some clues as to how to minimize osteolysis at the prosthesis-host junction after modular prosthesis fixation.

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