• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.18-25
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• 2024

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique. Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery. Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107°(±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19). Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.95-100
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• 2000

Objective : Posterior transarticular screw fixation is known to be one of the best surgical method for the atlantoaxial instability. We assessed the complication and operative risk in 15 patients. Patients and Methods : Between January 1997 and April 1998, 15 patients suffering from this condition were admitted to our institution. Atlantoaxial instability was caused by C1 or C2 fractures in 11, rheumatoid arthritis in 2, and os odontoideum in 2. This technique was used in the treatment of 13 patients and 2 patients was used in sublaminar wire fixation only. Bilateral C1-C2 screws were placed in 11 patients ; 2 patients had only one screw placed becauce of an anomalous vertebral artery and axial destruction. Follow-up period ranged from 5 to 20 months. Results : Most screws were positioned satisfactorily. One screw was malpositioned. No patients had neurological complications. Conclusion : Rigidly fixating C1-C2 instability with transarticular screws showed a significantly higher fusion rate than that achieved using wired grafts alone. The risk of screw malpositioning and catastrophic vascular or neural injury is small and can be minimized by assessing the position of the transverse foramen on preoperative computed tomographic scans and by correctly using intraoperative fluoroscopy and surgeon's precaution.

• Journal of Chest Surgery
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• 제45권6호
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• pp.351-367
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• 2012

This second report in the series on coronary artery bypass presents the authors experience and personal views on the internal thoracic artery (ITA) which date to 1966. There has been a very gradual evolution in the acceptance of this conduit which was initially compared with the saphenous vein and viewed as an improbable alternative to it. As is common with concepts and techniques which are 'outside the box' there was skepticism and criticism of this new conduit which was more difficult and time consuming to harvest for the surgeon who had to do it all. It was viewed as small, fragile, spastic and its flow capacity was questioned. Only a few surgeons employed it because of these issues and some of them would frequently graft it to the diagonal artery as it was thought not to supply adequate flow for the left anterior descending unless it was small. After a decade, angiographic data revealed superior patency to vein grafts. Even this evidence and survival benefit reported a few years later did not convince many surgeons that their concerns about limitations justified its use. Thus widespread adaption of the ITA as the conduit of choice for the anterior descending required another decade and bilateral use is only now expanding to more than 5% of patients in the US and somewhat faster in other countries.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.7.1-7.5
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• 2019

Background: To introduce a novel technique for advancement genioplasty helping surgeons to avoid soft tissue difficulties especially in short-faced patients with deep mentolabial fold and everted lower lip. Case presentation: In a trapezius-shaped, osteotomy was performed in the chin region. The mobilized segment was advanced, and the existing gap was grafted using interpositional allograft materials. Each side had been fixated by three-hole plates and two screws. The outcomes revealed no change in lower anterior teeth vitality. The patients did not report any changes of sensation in lower lip and chin either. The measurements indicated no increase in depth of mentolabial fold in patients undergoing this surgical technique. The postoperative evaluation showed a successful esthetic outcome for the patient and the surgeon concurrently. Conclusion: Based on our experience, the authors concluded that the Balcony technique is a simple and reliable procedure for patients with a deep mentolabial fold.

• Imaging Science in Dentistry
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• 제44권2호
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• pp.155-160
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• 2014

Purpose: The purposes of this study were to develop a workstation computer that allowed intraoperative touchless control of diagnostic and surgical images by a surgeon, and to report the preliminary experience with the use of the system in a series of cases in which dental surgery was performed. Materials and Methods: A custom workstation with a new motion sensing input device (Leap Motion) was set up in order to use a natural user interface (NUI) to manipulate the imaging software by hand gestures. The system allowed intraoperative touchless control of the surgical images. Results: For the first time in the literature, an NUI system was used for a pilot study during 11 dental surgery procedures including tooth extractions, dental implant placements, and guided bone regeneration. No complications were reported. The system performed very well and was very useful. Conclusion: The proposed system fulfilled the objective of providing touchless access and control of the system of images and a three-dimensional surgical plan, thus allowing the maintenance of sterile conditions. The interaction between surgical staff, under sterile conditions, and computer equipment has been a key issue. The solution with an NUI with touchless control of the images seems to be closer to an ideal. The cost of the sensor system is quite low; this could facilitate its incorporation into the practice of routine dental surgery. This technology has enormous potential in dental surgery and other healthcare specialties.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.92-99
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• 2003

스포츠 활동과 사고로 인하여 전방십자인대 재건술이 많이 증가하고 있으며 여러 종류의 자가 및 동종이식건이 많이 사용되어지고 있다. 자가 골-슬개건-골을 이용한 전방십자인대 재건술이 제일 대표적인 이식건으로 사용되고 있으나 공여부의 합병증과 전방슬관절통 등의 문제가 발생될 수 있으며 환자에 따라서 이러한 문제를 줄일 수 있는 다른 이식건의 사용도 필요할 수 있다. 여러 이식건의 생역학적인 특성, 장점 및 단점, 합병증을 충분히 이해함으로써 환자 개인에 맞는 적절한 이식건을 선택할 수 있으며 수술후 환자의 만족도를 높일 수 있을 것으로 생각된다

• Archives of Plastic Surgery
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• 제32권1호
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• pp.131-134
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• 2005

It is often difficult to identify and localize intraorbital foreign bodies despite of modern high-resolution imaging investigation. Especially, posteriorly located foreign bodies have increased risks of morbidity that surgical approach is often complicated. No matter how trivial it seems, retained foreign body, particularly organic in nature, may give rise to severe orbital and cerebral complications. High clinical suspicion, proper diagnostic studies, timely referral to a skilled orbital surgeon are mandatory. We report a case of intraorbital wooden foreign body that required two separate exploration for removal. Initial exploration failed to identify and locate the foreign body completely. After the operation, fistula formation and purulent discharge were developed and the imaging investigation results were equivocal, complicating the management. A second exploration yielded multiple intraorbital wooden foreign body in the apex of orbit. The patient fully recovered without complication. The evaluations and the details of management strategy are discussed.

• Journal of Chest Surgery
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• 제5권1호
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• pp.29-34
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• 1972

Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

• 대한디지털의료영상학회논문지
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• 제5권1호
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• pp.26-31
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• 2002

본 연구의 목적은 복강경 수술환경에서 2D와 3D 내시경 비디오 영상이 수술에 미치는 영향을 평가하기 위한 연구이며, 이를 위해 3D 내시경 시스템을 구성하고 성능 평가를 수행하였다. 결과적으로 본 연구에서 제안한 3D 방식이 기존의 전자셔터 방식에 의한 3D 영상에 비해 화질과 시야각이 우수하며, 2종류의 모의 수술 실험 비교를 한 결과, 제안한 방식의 디지털 영상을 이용하는 경우가 성능이 가장 우수함을 정량적으로 확인하였다.

• 대한골관절종양학회지
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• 제13권2호
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• pp.201-206
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• 2007

연부조직 육종의 치료에서 광범위 절제술은 필수적이며, 국소 재발율은 수술시 절제연과 매우 밀접한 관계를 가지는 것으로 알려져 있다. 연부조직 육종이 뼈와 바로 접하여 있는 경우 치료의 방향을 정하는데 어려움이 있다. 인접 골을 같이 절제하지 않으면 충분한 절제연을 얻을 수가 없고, 뼈를 같이 절제하면 수술이 어려워지면서 많은 합병증을 가져 올 수 있는 재건술이 필요해진다. 저자들은 슬와부 신경 및 혈관 과 근위 경골 사이에 발생하여 경골을 침투한 활막육종을 치료한 경험을 증례 보고한다.