• Title/Summary/Keyword: Surgical Management

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MANAGEMENT OF IMPACTED TEETH BY AUTOTRANSPLANTATION IN CHILDREN (소아에서 자가치아이식에의한 매복치의 처치)

  • Ryu, Hyun-Seop;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.4
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    • pp.564-572
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    • 2000
  • We decided among extraction, orthodontic traction and autotransplantation such as direction and position of unerupted tooth, degree of developing root apex, eruption space, being of supernumerary tooth or odontoma or cyst when tooth impacted. Autotransplantation is considered when orthodontic traction is unrealistic or when tooth movement can absorb root of neighbor tooth. The prognosis for successful autotransplantation is dependent on a number of factors such as root development, surgical technique, patient's age, endodontic treatment, time and type of splinting, preservation of periodontal ligament and storage medium. Especially when severe osseous defect is being, bone graft considered for reducing of mobility and for assisting recovery. In all cases, chief complaint is unerupted tooth and various causing factors were supernumerary, odontoma, ectopia and so on. Before autotransplantation, space regaining was done if needed and demineralized freezed dried bone and autogenous bone graft was done when there is severe osseous defect by extraction of supernumerary tooth or odontoma. Splinting was removed after 2-3weeks At 3-4weeks after autotransplantation, endodontic treatment was decided. At follow up check, normal recovery was done and there was no inflammatory or replacement root resorption in periapical radiograph.

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Regenerative Endodontic Treatment of Infected Immature Permanent Teeth with Dens Invaginatus : A Report of Two Cases (치내치를 동반한 감염된 미성숙 영구치의 재생형 근관치료)

  • Shin, Gayoung;Lee, Kwanghee;An, Soyoun;Song, Jihyun;Heo, Narang;Ra, Jiyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.188-196
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    • 2015
  • Endodontic management of an immature permanent tooth with dens invaginatus poses a challenge to efficient treatment planning for the clinicians. Because it is difficult to shape, disinfect, and seal the canal space effectively, teeth with complex root canal structures often require particularly extensive and thorough treatment approaches. The purpose of this case report was to share clinical insight from the results of short-term follow-ups after regenerative endodontic treatment with a dens invaginatus. Two immature maxillary lateral incisors with Oehlers type I and III dens invaginatus and infected necrotic pulp were treated using regenerative endodontic procedures. For the type III dens invaginatus case, an unusual approach toward redesigning the complex internal structure was taken, in order to have sufficient infection control and sealing. Cone-beam computed tomography (CBCT) and a surgical operating microscope were used to aid visualization and treatment. As a result, regenerative endodontic treatment appears to be effective for managing immature permanent teeth with complex dens invaginatus, and can lead not only to clinical and radiographic resolution, but also increased thickness of the dentinal walls.

A Case of Tracheal Hamartoma (기관내 과오종 1예)

  • Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Sung, Sook-Hwan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.383-388
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    • 1999
  • Background: Tracheal hamartoma is a very rare cause of upper airway obstruction. Its clinical features can mimic medical conditions, such as bronchial asthma, chronic bronchitis, and so on. Case; This report presents the case of a 65 year old man whose major symptom was dyspnea. We found a tumor in his distal tracheal lumen, and the tumor was removed with success using rigid bronchoscope. The tumor was histologically proven to be a hamartoma, and his symptoms were much improved. Conclusion: It is important to distinguish it from other conditions because medical management is often not helpful. Surgical correction-with or without thoracotomy-is inevitable.

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The clinical study for the postoperative tracheal stenosis (수술후성 기관협착증에 관한 임사적 고찰)

  • 김기령;홍원표;이정권
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.9.1-10
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    • 1977
  • Many etiological factors playa significant role in the development of tracheal stenosis; too high tracheostomy (Jackson, 1921), too small stoma (Greisen, 1966), the treatment with respirator using cuffed tube (Pearson et al., 1968; Lindholm, 1966; Bryce, 1972) and infection (Pearson, 1968). Although the incidence has been reduced due to development of surgical technique and antibiotics, the frequency of tracheal stenosis which produces symptoms after tracheostomy ranges from 1.5 per cent (Lindholm, 1967). In the management of the stenosis, mild cases are treated by mechanical dilatation with silicon tube or stent (Schmigelow, 1929; Montgomery, 1965) combined steroid (Birck, 1970), and in the cases of stenosis causes, these removed under the are bronchoscopy. But in severe stenosis, transverse resection with subsequent end-to-end anastomosis has been used in recent years (Pearson et al., 1968). During about 10 years, 1967 to 1977, a total of 23 patients with tracheal stenosis complicated among the 1, 514 tracheostomies have been treated in Severance Hospital. Now, we have obtained following conclusions by means of clinical analysis of 23 cases of tracheal stenosis. 1. The frequency of tracheal stenosis was 23 cases among 1, 514 cases of tracheostomy (1.5%). 2. Under the age of 5, these are 12 cases (52.2 %). 3. The sex incidence was comprised of 18 males and 5 females. 4. The duration of tracheostomy ranges from 4 days to 16 months. 5. The primary diseases requiring tracheostomy were following; central nerve system lesions 11 cases, upper air way obstruction 10 cases, extrinsic respiratory failure 2 cases. 6. Severe wound infections were only 2 cases. 7. The methods of treatment applied to tracheal stenosis were following; closed observation only 5 cases, nasotracheal intubation combined steroid 5 cases, T-tube stent combined steroid 3 cases, fenestration op. 4 cases, revision 4 cases and transverse resection and end-to-end anastomosis 2 cases.

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A Study on the Air Counts and the Infection of Maternity in n General Hospital (병실 낙하균 및 산모감염에 관한 연구)

  • 이남희
    • Journal of Korean Academy of Nursing
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    • v.9 no.2
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    • pp.17-26
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    • 1979
  • This research is to prevent the infection of maternity in the hospital by examining the microbes contaminations in maternity through airbone microbes and those who are engaged in the ward of O.B. & G.Y. and to furnish the basic data available to hospital management. The bacterial growth of airbone microbes contaminations in nosocomial air and who thor the nasal cavity of passers by (doctors, nurses, parturient women) who went to the ward of O.B. & G.Y. contaminated or not were examined in“E”Univ. Hospital from July to August, 1979 by using thioglycollate broths and agar plates. The following results were obtained: 1. The average colony number of airborne microbes revealed as follows the pediatric ward (36 colonies), the internal ward (33 colonies), the ward of O.B. & G.Y. (30 colonies), the ward of surgery (24 colonies), delivery-waiting room (11 colonies), and the delivery room (3 colonies). 2. The bacterial growth beforenoon differed from that of afternoon. Namely, the latter (24 colonies) was higher than the former (21 colonies). 3. The type of strains isolated from the air of the ward revealed staphylococci (82%), Gram negative bacilli (18%), fungi (17%), Gram positive diplococci (13%), and Bacillus subtilis (2.8%). 4. The strains isolated in the delivery-waiting room revealed staphylococci (66.7%), Gram negative bacilli (33.6%), and revealed staphylococci (75%), Gram positive diplococci (8.3%), and fungi (8.3%), in delivery room. 5. Most of strains isolated in the ward of O.B. & G.Y. revealed staphylococci (100.0%), Gram positive diplococci (8.3%), and Gram negative bacilli (6.7%). 6. The strain isolated in the surgical ward revealed staphylococci (91.7%), fungi (33.3%), Gram positive diplococci (25%), Gram negative bacilli (25%) and Bacillus subtilis (8.3%). 7. The strain isolated in the pediatric ward revealed staphylococci (75%), fungi (25%), Gram positive diplococci (8.3%), Bacillus subtilis (8.3%), and Gram negative bacilli (8.3%). 8. The strain isolated in the internal ward revealed staphylococci (91.7%), fungi (33.3%), Gram positive diplococci (25%), and negative bacilli (16.7%). The strains isolated from the nasal cavity of those doctors and nurses who and enaged in the ward of O.B. & G.Y. revealed staphylococci (80%), Bacillus subtilis (10%), and Gram negative bacilli (10%), from doctors and Gram positive diplococci (10%), instead of Gram negative bacilli (10%), from nurses. 10. The strain isolated from nasal cavity of parturient women on admission revealed staphylococci (90%), and Gram negative bacilli (10%), but after admission revealed staphylococci (70%), Gram positive diplococci (10%), and Gram negative bacilli (10%). 11. Of the total 91 staphylococci isolated from the air of the ward, the Coagulase pastive was 36 (39.6%), and the negative 55 (60.4%), As a result of the coagulase experiment of the staphylococci isolated from the nasal cavity of those who are engaged in the ward of O.B. & G.Y. all were revealed as negative that belonged to non-pathogenic. 12. Consequence of the biochemic examination of the gram negative bacilli isolated from the air of the ward the aerobacter aerogens revealed was (16.7%) E-coli 5% in the nasal cavity of those came and went to the of O.B. & G.Y. and Aerobacter aerogens 7.5%.

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The Effect of Aroma Inhalation on the Preoperative Pain and Anxiety of the Elderly Preparing to Undergo Spine Surgery (척추 수술 전 노인환자에게 적용한 아로마 향흡입요법이 통증 및 불안에 미치는 효과)

  • Park, Sohwi;Kim, Bokyoung;Park, Kyungsook
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.523-533
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    • 2019
  • This study's purpose is to determine the effects of aroma inhalation on preoperative pain and anxiety of the elderly preparing to undergo a spine surgery. A Quasi-experimental design, with non-equivalent control group non-synchronized design was used in this study. Blended essential oils with frankincense, marjoram and mandarin were inhaled twice in the experimental group (n=30). The control group (n=30) was treated with the standard preoperative care. Pain, state anxiety, and vital sign were measured twice (before and after). The results of this study showed that pain (t=-1.223, p=.226), systolic blood pressure (t=-0.211, p=.833), diastolic blood pressure (t=0.638, p=.526), and respiration rate (t=0.734, p=.466) were not statistically significant in the experimental and the control group. There were significant differences in state anxiety (t=-3.202, p=.002) and pulse rate (t=-0.213, p=.037) in the experimental group compared to the control group. According to the results, aroma inhalation is an effective nursing intervention for relieving anxiety in surgical patients.

Acute Pancreatitis in Children (소아 급성 췌장염의 임상적 고찰)

  • Cho, Jae-Ho;Lee, Tae-Seok;Ko, Young-Gwan;Oh, Soo-Myung
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.17-25
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    • 1996
  • Acute pancreatitis(AP) in children is not common but can be associated with severe morbidity rates and its diagnosis is often delayed. Thus, reported mortality rates range from 0 to 78%. We have treated 26 patients with AP from 5 to 17 years of age over the past 17 years. We are intended to assess the relevance of the prognostic criteria used to assess severity of adult AP and to review the etiology, clilical presentation, diagnosis, and management of AP in children. The authors retrospectively reviewed 26 children with AP managed in Kyung Hee University Hospital from 1978 to 1995. Among 26 patients with AP, male were 12, and female were 14. And the mean age of patients was 11.8 years. In 9(34.6%), no definitive cause was identified. Common causes of AP were trauma(23.1%) and biliary tract disease(23.1%). Other etiologies were viral infection(15.4%) and post ERCP(3.8%). The presenting features were abdominal pain(92.3%), vomiting(61.5%), fever(19.2%), submandibular pain(11.5%), and abdominal mass(7.6%). Back pain was rare(3.8%). Abdominal ultrasonographic findings were abnormal in 10 of 16 patients(62.5%) and abdominal CT findings were abnormal for 9 of 9 patients(100%). Seventeen patients(65.3%) were managed conservatively, and nine patients(34.6%) required surgical treatment. There was no mortality. To evaluate the severity of disease, we used the Imrie prognostic criteria used to assess the severity in adult AP. The number of positive criteria was correlated to the duration of hospitalization(r2=0.91) but statistically insignificant(p>0.05). But, the number of positive criteria was correlated to the operative incidence(r2=0.93) and statistically significant(p<0.05). The common causes of AP in children were unknown origin(34.6%), trauma(23.1%), and biliary tract disease(23.1%). Ultrasonography and computed tomography were useful imaging tools of AP in children. The Imrie criteria used to evaluate the severity in adult AP were suspected to be valuable to assess the severity of AP in children.

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ERUPTION DISTURBANCE OF THE LOWER LEFT FIRST PERMANENT MOLAR CAUSED BY AMELOBLASTIC FIBROMA (법랑모세포섬유종에 의한 하악 제1대구치의 맹출 장애)

  • Kim, Seung-Hye;Song, Je-Seon;Son, Heung-Kyu;Choi, Hyung-Jun;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.102-108
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    • 2010
  • Impaction is the cessation of eruption process caused by physical obstacles on the eruption pathway, abnormal tooth position, or lack or space. It often occurs in association with supernumerary teeth, odontogenic tumor, or cystic lesions, and ameloblastic fibroma is one of the odontogenic tumors that can cause impaction of teeth. In many cases, ameloblastic fibroma occurs in association with one or more unerupted teeth. The proper management of ameloblastic fibroma is determined between conservative resection or more aggressive block resection, based size and morphologic features of the lesion and age of the patient. This is a case of a 8 year and 6 month old boy whose lower left permanent molar showed eruption disturbance. The impacted tooth was successfully repositioned favorably through surgical exposure and orthodontic traction using a modified halterman appliance. Long term follow-up, longer than 10 years, is planned considering relatively high recurrence rate and possibility of malignant transformation of ameloblastic fibroma, which cause impaction of the lower left permanent molar in this case.

Successful Pulmonary Resection Combined with Chemotherapy for the Treatment of Mycobacterium avium Pulmonary Disease : A Case Report (내과적 치료와 함께 폐절제술을 시행하여 균음전에 성공한 Mycobacterium avium 폐질환 1례)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kim, Kwhanmien;Lee, Nam Yong;Han, Joungho;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.6
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    • pp.621-627
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    • 2003
  • The Mycobacterium avium complex (MAC) is the most common pathogen causing nontuberculous mycobacterial pulmonary disease. Despite the introduction of newer, more effective agents for the treatment of MAC, such as clarithromycin, the response to drug therapy in MAC pulmonary disease remains poor, and often frustrating. When MAC pulmonary disease has not been successfully eradicated using drug treatment alone, surgical management is still recognized to play a significant role. A case of MAC pulmonary disease, in a patient whose MAC disease was successfully treated by pulmonary resection, following the failure of drug therapy containing clarithromycin, is reported. To our knowledge, this is the first case report in Korea that the patient underwent a pulmonary resection for the treatment of MAC pulmonary disease.

Utility of Surgical Resection in the Management of Metachronous Krukenberg's Tumors of Gastric Origin

  • Kim, Gwon-Sik;Kim, Kap-Choong;Kim, Beom-Su;Kim, Tae-Hwan;Yook, Heong-Hwan;Oh, Sung-Tae;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.10 no.3
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    • pp.111-117
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    • 2010
  • Purpose: The aim of this study was to determine the prognostic factors and the significance of metastatectomy for Krukenberg's tumors of gastric origin.Materials and Methods: Among the patient who underwent gastric surgery from 1992 through 2005, 90 female patients with Krukenberg's tumors of gastric origin were identified. We retrospectively reviewed the clinicopathologic characteristics, prognostic factors, and treatments for primary gastric cancer. We also investigated the prognostic risk factors for the onset of metachronous Krukenberg's tumors and the survival time of patients who underwent an operation for metachronous Krukenberg's tumors. Results: The presence of a synchronous Krukenberg's tumor (mean survival time=17.6 months, P<0.01), peritoneal seeding (14.5 months, P<0.01), and non-curative resection (15.1 months, P<0.01), were statistically significant prognostic factors for survival time in female patients with gastric cancer. The stage of primary gastric cancer (P=0.049) and lymph node metastasis (P=0.011) were statistically significant risk factors for recurrence time of a metachronous Krukenberg's tumor. In the metachronous Krukenberg's tumor group (n=53), the mean survival time of the metastatectomy group (n=46, 43.2 months, P=0.012) was longer than that in the chemotherapy or conservative treatment groups (n=7 and 24 months, respectively). Metastatectomy, presense or abscence of residual tumor and extent of residual tumor were significant prognostic factors for survival time in female patients with metachronous Krukenberg's tumor of gastric origin. Conclusions: A close observation and evaluation with ultrasound or computed tomography is necessary in female patients with advanced gastric cancer to detect a metachronous Krukenberg's tumor as soon as possible. The surgeon must operate more aggressively in patients with metachronous Krukenberg's tumors.