• Title/Summary/Keyword: Sacred Site

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Arthroscopic Meniscal Repair with Rapid Loc Device (Rapid Loc 기기를 이용한 관절경적 반월상 연골판 봉합술)

  • Kwon, Duck-Joo;Lee, Kee-Byung;Joeng, Woong-Kyo;Lee, Byung-Taek;Park, Sang-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.180-185
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    • 2005
  • Purpose: To purpose of this study is to evaluate the clinical and radiological results of arthroscopic meniscus repair using Rapid Loc device. Materials and Methods: A retrospective study was performed on 44 cases which had been turned out longitudinal tear without degeneration. We repaired all cases with Rapid Loc device. Patients were evaluated using clinical examination, Orthopaedische Arbeitsgemeinschaft Knie (OAK) scheme, and MRI. We regarded patients with joint line tenderness, swelling or McMurray positive test as clinical failure. Results: A mean age was 33.3 years and follow-up period was average 15 months. Clinical results were excellent 15 cases(34.1%), good 20 cases(45.5%), fair 7 cases(15.9%), poor 2 cases(4.5%). MRI showed grade 115 cases(33.3%), grade II 22 cases(50%), grade III 7 cases(16.7%). Clinical failures were 8 cases and only one complication was developed. Conclusion: Rapid Loc device showed the excellent results in meniscus repair. We regard it has a lot of advantages in safety, softness, ease, ability to control tension at repair site.

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The Overlapping Running Suture Method Using Single Knotless Barbed Absorbable Suture Material for Abdominal Wall Closure after Single Incision Laparoscopic Appendectomy: Comparison with the Traditional Interrupted Closure Technique

  • Kim, Dong Hyun;Park, Jung Ho;Joo, Jung Il;Jeon, Jang Yong;Lim, Sang Woo
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.160-167
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    • 2018
  • Purpose: The aim of our study was to present an abdominal wall closure technique using barbed suture $V-Loc^{TM}$ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA. Methods: From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture $V-Loc^{TM}$ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time ($40.0{\pm}15.4min$ vs. $44.9{\pm}16.3min$, p=0.013) and abdominal wall cusing continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time losure time ($5.5{\pm}0.9min$ vs. $6.5{\pm}0.8min$, p<0.001). Postoperative incision length was significantly shorter in the V-Loc closure group ($1.1{\pm}0.3cm$ vs. $1.8{\pm}0.4cm$, p<0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups. Conclusion: In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.

Resonance Condition of the Resonance Cavity and Air Gap in the Sacred Bell of the Great King Seongdeok (성덕대왕신종의 명동과 간극의 공명조건)

  • Kim, Seock-Hyun;Jeong, Won-Tae;Kang, Yun-June
    • The Journal of the Acoustical Society of Korea
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    • v.30 no.4
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    • pp.223-230
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    • 2011
  • Korean bell is hung with some air gap between the bell bottom and the ground. In addition, it has a peculiar acoustic element, so called resonance cavity below the bell. A proper design of the air gap and cavity size dramatically amplifies the bell sound by resonance effect. Bell interior cavity, air gap and resonance cavity consist of an acoustic cavity system. When the acoustic cavity frequency coincides with the natural frequency of the bell body, the frequency component is significantly amplified. On the Sacred Bell of the Great King Seongdeok, this study proposes a resonance condition of the cavity system considering air gap effect for the first time. With the exact dimension of the bell, boundary element analysis is performed using SYSNOISE. Finally, this study reveals how the temperature in season influences the resonance condition and proposes a concept of variable type resonance cavity. By using the variable type resonance cavity, the cavity size is controlled on site and exact resonance is available regardless of temperature difference in season.

A Patient with Cellulitis from Intramuscular Glyphosate Injection (Glyphosate 근주 후 발생한 봉와직염 1례)

  • Kim, Yoon-Sung;Ohk, Taek-Gun;Shin, Myeung-Cheol;Choi, Hyun-Young;Moon, Joong-Bum;Kim, Sung-Eun;Seo, Jeong-Yeul;Ahn, Moo-Eob;Cho, Byung-Ryul;Kim, Yang-Hoon;Lee, Bong-Ki;Kim, Myeung;Cho, Jun-Hwi
    • Journal of The Korean Society of Clinical Toxicology
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    • v.5 no.1
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    • pp.71-73
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    • 2007
  • Glyphosate is the active ingredient in widely used herbicides. It acts through inhibition of the shikimate metabolic pathway in plants. This pathway does not exist in mammals, however, so glyphosate is presumably less toxic to humans. Nevertheless, fatal cases of glyphosate poisoning in humans have still occurred. Cases of glyphosate poisoning reported in the previous literature were almost always caused by intentional ingestion. Therefore, intramuscular injection of glyphosate with suicidal intent has not been reported. We report a case of 43-year-old man with poisoning due to intramuscular injection of glyphosate herbicide. He was admitted to the emergency department with a chilling sensation, local hotness, swelling, and tenderness at the site of glyphosate injection. He was treated with intravenous antibiotics and analgesics for 10 days and was discharged without any other complication.

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Surgical Management of Bisphosphonate Related Osteonecrosis of the Jaw Using Pedicled Buccal Fat Pad Flap (비스포스포네이트 연관 악골 괴사증 환자에서 유경 협부 지방 피판을 이용한 치료)

  • Lee, Jang-Ha;Kim, Min-Keun;Kim, Seong-Gon;Park, Young-Wook;Park, Sang-Wook;Park, Young-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.174-177
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    • 2013
  • Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a disease characterized by jaw necrosis and delayed wound healing in patients who had received bisphosphonates. Buccal fat pad (BFP) can be used as a pedicled flap in the posterior region of the oral cavity. BFP pedicle flap needs simple surgical technique and it shows less donor site morbidity and aesthetic problem than other vascularized flap. BFP pedicled flap was fed by 3 arteries-facial, internal maxillary, and transverse facial artery. Osteomyelitis was generally related with poor blood supply. Thus, rich blood supply of BFP pedicle flap can have a potential advantage to BRONJ patients. In this case report, we presented 3 BRONJ patients treated by BFP pedicle flap after sequestrectomy.

The Extensor Digitorum Brevis Muscle Island Flap for Soft Tissue Loss Around the Ankle and Distal Foot (단족지 신전근 도상 피판에 의한 족부 및 족관절부의 연부조직 수복)

  • Choi, Soo-Joong;Jun, Byoung-Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.14 no.2
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    • pp.131-137
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    • 2005
  • The extensor digitorum brevis (EDB) muscle island flap is a reliable, safe method for coverage of foot and ankle. There are many variation in approach such as curvilinear, zigzag, L-shaped or vertical longitudinal incision for exposure of the EDB muscle. These approaches use only single incision excluding the distal incision for exposure of the distal tendon. Since dorsalis pedis artery vascular bundle and sinus tarsi branch of the lateral tarsal artery both requires careful dissection, single incision alone may cause not only difficulty in exposure but also skin sloughing at donor site. So we tried to modify the approach into two parallel longitudinal incision, one for dorsalis pedis vascular bundle and the other for sinus tarsi branch exposure. The author treated 9 patient with EDB muscle flap. We used single incision in six patients, and two parallel incision in three patients. All the flap survived. In two parallel incision group, dissection was more easy and rapid. So we would like to suggest that two parallel longitudinal incision approach is better method than the single incision technique for exposure of the EDB muscle flap.

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Anatomical study to determine a new approach to treat benign masses located in the anterior condyle region: a case report

  • Sin Guen Kim;Sung Chul Bok;Suk In Choi;Jun Woo Park;Dong Ju Choi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.2
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    • pp.110-115
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    • 2024
  • A 22-year-old male patient presented to the clinic with severe pain in the preauricular area with an inability to completely occlude the jaw. Facial computed tomography and magnetic resonance imaging revealed a well-defined lesion that was tentatively diagnosed as a benign tumor or cystic mass. Surgical approach of a lesion in the condyle is delicate and problematic as many vulnerable anatomical structures are present. There are several methods for surgery in this area. Typically, an extraoral approach is dangerous because of potential injuries to nerves and arteries. The intraoral approach also presents difficulties due to the lack of visibility and accessibility. On occasion, coronoidectomy may be performed. The goal here was to determine an easier and safer new surgical approach to the condyle. We reached the anterior part of the pterygoid plate in the same method as in Le Fort I surgery. From this point, through the external pterygoid muscle, approaching the anterior aspect of the condyle is relatively easy and safe, with minimal damage to the surrounding tissues. Pus was drained at the site, and the lesion was diagnosed as an abscess. Pain and inability to close the mouth resolved without recurrence.

Surgical Site Infection Rates according to Patient Risk Index after General Surgery (일반외과 환자의 환자위험지수에 따른 수술창상감염 발생률)

  • Lee, Hye-Ryeong
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.1
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    • pp.44-51
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    • 2002
  • Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

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The Medial Sural Artery Perforator Flap: A Historical Trek from Ignominious to "Workhorse"

  • Hallock, Geoffrey G.
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.240-252
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    • 2022
  • Rather than just another "review," this is intended to be an "overview" of the entire subject of the medial sural artery perforator (MSAP) flap as has been presented in the reconstructive literature from its inception in 2001 until the present, with any exceptions not purposefully overlooked. Unfortunately, the pertinent anatomy of the MSAP flap is always anomalous like most other perforator flaps, and perhaps even more variable. No schematic exists to facilitate the identification of a dominant musculocutaneous perforator about which to design the flap, so some adjunctive technology may be highly valuable for this task. However, if a relatively thin free flap is desirable for a small or moderate sized defect that requires a long pedicle with larger caliber vessels, the MSAP flap deserves consideration. Indeed, for many, this has replaced the radial forearm flap such as for partial tongue reconstruction. Most consider the donor site deformity, even if only a conspicuous scar on the calf, to be a contraindication. Yet certainly if used as a local flap for the knee, popliteal fossa, or proximal leg, or as a free flap for the ipsilateral lower extremity where a significant recipient site deformity already exists, can anyone really object that this is not a legitimate indication? As with any perforator flap, advantages and disadvantages exist, which must be carefully perused before a decision to use the MSAP flap is made. Perhaps not a "workhorse" flap for general use throughout the body, the MSAP flap in general may often be a valuable alternative.

Association Between Prophylactic Antibiotic Use and Surgical Site Infection Based on Quality Assessment Data in Korea (요양급여적정성 평가자료를 이용한 예방적 항생제 사용과 수술부위 감염 발생의 관련성 연구)

  • Kim, Kyoung-Hoon;Park, Choon-Seon;Chang, Jin-Hee;Kim, Nam-Soon;Lee, Jin-Seo;Choi, Bo-Ram;Lee, Byung-Ran;Lee, Kyoo-Duck;Kim, Sun-Min;Yeom, Seon-A
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.3
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    • pp.235-244
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    • 2010
  • Objectives: To examine the prophylactic antibiotic use in reducing surgical site infection. Methods: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. Results: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. Conclusions: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.