• Title/Summary/Keyword: Surgical result

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Sepsis Developed from an Odontogenic Infection (근막간극감염에 의한 패혈증 연구)

  • Jeong, Mi-Ae
    • Proceedings of the KAIS Fall Conference
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    • 2011.12a
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    • pp.326-329
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    • 2011
  • Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant micro-organisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.

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High-pressure Injection Injuries in the Hand (수부의 고압 분사 손상)

  • Kim, Seong-Ki;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyung-Moo
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.245-249
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    • 2010
  • Purpose: High-pressure injection injury is caused by accidental injection of the high-pressure injection devices in industry. The initial benign appearance of the wound fools patients into delays in an adequate treatment. And it can result in disastrous outcomes such as necrosis and amputation. To avoid the poor prognosis, the injuries require a prompt surgical intervention. The purpose of this article is to recognize the poor outcome of the highpressure injection injury and to introduce an adequate treatment in need. Methods: We have 4 cases of the high-pressure injection injuries in the hand from April, 2005 to March, 2009. Average age is 39 years (30 - 49 years old), 2 cases are the palm of dominant hand, 1 case is the thumb of dominant hand, and 1 case is the palm of non-dominant hand, respectively. We followed up these patients for 20 months on average. In 3 cases, the immediate, aggressive surgical intervention was carried out, but the other one was delayed in early adequate treatment. The wounds were covered by local advancement flap, anterolateral thigh free flap, conservative treatment with antibiotics and dressing. Results: No pathogens after culture were found nor any findings of fracture in imaging study. Conservative treatment, local advancement flap and anterolateral thigh free flap for the open wound resulted in a desirable aesthetic outcome. In a long-term follow up, functional capability of the patient was also satisfactory. Conclusion: Upon initial evaluation, most high-pressure injection injuries present as innocuous wounds with very few symptoms and result in delaying the proper management. And the majority of high-pressure injection injuries will produce significant morbidity to the hand, amputation. And the initial aggressive surgical debridement was needed to prevent the poor outcome. The key to success in treating high-pressure injection injuries of the hand is the prompt aggressive surgical intervention.

Surgical Treatment of Radial Nerve Injury (요골 신경 손상의 수술적 치료)

  • Lee, Kwang-Suk;Park, Sang-Won;Wie, Dae-Gon
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.128-136
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    • 1996
  • Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

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Effect of Feedrate and Specimen Shape on Cutting Force and Surface Roughness of Ultrasonic Dental Surgical Instrument (치과용 초음파 수술기의 이송속도 및 시편형상이 절삭반력과 표면거칠기에 미치는 영향)

  • Sang Ho Kim;Seung Han Yang;Joong Ho Lee;Jong Kyun Choi
    • Journal of Biomedical Engineering Research
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    • v.44 no.2
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    • pp.109-117
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    • 2023
  • In this study, the effect of the shape of the specimen and the feedrate of the dental ultrasonic surgical instrument on the cutting force and surface roughness of the specimen is analyzed. Experimental specimens were made of SAWBONES artificial bone materials in square and spherical specimens. In addition, the cutting feedrate of the surgical instrument was controlled through the developed moving system. The cutting force generated when cutting the specimen was measured through a force sensor. After the experiment, the cutting surface of the specimen was observed through a three-dimensional optical microscope and the surface roughness was measured. Through one-way ANOVA, the effect of each specimen shape and feed rate on surface roughness was analyzed. As a result of the experiment, the cutting force increased proportionally in the initial feed rate increase stage, but the increase in cutting force decreased as the feed rate continued to increase. Also, the cutting force showed a difference according to the shape of the specimen. The spherical specimen with a relatively small cutting surface area had less cutting force than the square specimen. However, as a result of one-way ANOVA, it was found that the specimen shape and feed rate did not affect the surface roughness. In future studies, it is expected to be used for comparative analysis of ultrasonic surgical instruments and correlation analysis between cutting factors.

The Three-Bite Technique: A Novel Method of Dog Ear Correction

  • Jaber, Omar;Vischio, Marta;Faga, Angela;Nicoletti, Giovanni
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.223-225
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    • 2015
  • The closure of any circular or asymmetric wound can result in puckering or an excess of tissue known as a 'dog ear'. Understanding the mechanism of dog ear formation is a fundamental requirement necessary to facilitate an appropriate treatment. Many solutions have been reported in the literature, but in all cases, the correction entails the extension of the scar and the sacrifice of the dermal plexus. Here, we propose a novel technique of dog ear correction by using a three-bite suture that sequentially pierces the deep fascial plane and each dog ear's margin, thus allowing for flattening the dog ear by anchoring the over-projecting tissue to the deep plane. The three-bite technique proved to be a fast, easy, and versatile method of immediate dog ear correction without extending the scar, while maintaining a full and complete local skin blood supply.

Surgical Treatment of the Nasopharyngeal Carcinoma (비인강암의 수술적 치료)

  • Lee Won-Sang;Chun Young-Myoung;Choi Heung-Seek
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.92-99
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    • 1996
  • The primary treatment of the nasopharyngeal carcinoma is at this time, mainly based on radiotherapy. In most studies for patient treated with radiotherapy, overall 5-year survival rate is in the range of 35 to 55%. Obviously, these therapeutic results may be influenced by various factors such as clinical stages, histopathological types and radiation techniques, etc. Though the radiotherapy had a good therapeutic result, there is a limitation to apply the radiotherapy only in cases of the advanced nasopharyngeal carcinoma. Anatomical complexity of the skull base and difficulties in complete surgical intervention were the trouble of the surgery but in the case of radiation failure, there is no adequate choice of other curative modalities. So it is appropriate to investigate whether surgical resection may improve the outcome of treatment of nasopharyngeal carcinoma. The purpose of this papaer is to report our surgical experience of the nasopharyngeal carcinoma, then to take into consideration of the new model of treatment strategy of nasopharyngeal carcinoma.

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A Simulation System of Total Knee Replacement Surgery for Extracting 3D Surgical Parameters (슬관절 전치환술용 3차원 시술변수 추출 시스템)

  • Jun, Yong-Tae
    • Korean Journal of Computational Design and Engineering
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    • v.16 no.5
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    • pp.315-322
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    • 2011
  • The goal of total knee replacement (TKR) surgery is to replace patient's knee joint with artificial implants in order to restore normal knee joint functions. Since mismatched knee implants often cause a critical balancing problem and short durability, designing a well-fitted implant to a patient's knee joint is essential to improve surgical outcomes. We developed a software system that three-dimensionally (3D) simulates TKR surgery based upon 3D knee models reconstructed from computed tomography (CT) imaging. The main task of the system was to extract precise 3D anatomical parameters of a patient's knee that were directly used to determine a custom fit implant and to virtually perform TKR surgery. The virtual surgery was simulated by amputating a 3D knee model and positioning the determined implant components on the amputated knee. The test result shows that it is applicable to derive surgical parameters, determine individualized implant components, rehearse the whole surgical procedure, and train medical staff or students for actual TKR surgery. The feasibility and verification of the proposed system is described with examples.

The Effectiveness of Occlusal Splint for the Treatment of Temporomandibular Joint Dislocation

  • Lim, Hyun-Dae;Lee, You-Mee;Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
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    • v.39 no.4
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    • pp.152-155
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    • 2014
  • Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

Surgical Treatment of the Nasopharyngeal Carcinoma (비인강암의 수술 치험)

  • Lee Won-Sang;Chun Young-Myoung;Youn Jung-Sun
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.2
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    • pp.200-209
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    • 1993
  • The primary treatment of the nasopharyngeal carcinoma is, at this time, mainly based on radiotherapy. In most studies for patient treated with radiotherapy, overall 5-year survival rate is in the range of 35 to 55%. Obviously, these therapeutic results may be influenced by various factors such as clinical stages, histopathological types and radiation techniques, etc. Though the radiotherapy had a good therapeutic result, there is a limitation to apply the radiotherapy only in cases of the advanced nasopharyngeal carcinoma. Anatomical complexity of the skull base and difficulties in complete surgical intervention were the trouble of the surgery but in the case of radiation failure, there is no adequate cholice of other curative modalities. So it is appropriate to investigate whether surgical resection may improve the results of treatment of nasopharyngeal carcinoma. The purpose of this paper is to report the surgical experience with nasopharyngeal carcinoma, then to take into consideration of the new model of treatment strategy of nasopharyngeal carcinoma.

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Is Postoperative Isoniazid Therapy Necessary for Regional Lymphadenitis Following BCG Vaccination? (BCG 접종후 발생한 림프선염의 외과적 치료후 Isoniazid 투여의 필요여부)

  • Shin, Kwan-Soo;Lee, Nam-Hyuk;Kim, Sang-Youn
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.1-5
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    • 1997
  • Regional lymphadenitis is the most common complication following BCG vaccination in this country. The literature describes controversial results with medical, surgical and combined therpy. The purpose of this study is to clarify the therapeutic effect of isoniazid(INH) after surgical procedures. The early and late postoperative complications of 136 children with lymphadenitis following BCG vaccination at the Taegu Fatima Hospital between March 1985 and February 1996 were reviewed. In 90 children, INH was given for 3-4 days before operation and for 3 months after surgery. In the other 46 cases, INH was not given during the pre- or postoperative period. Surgical procedures were excision or incision and currettage according to the states of lesions. Postoperative complications were fluid accumulation, wound infection, sinus formation and others. Complication rates were 14.4 % in INH-treated group and 13.0% of INH-nontreated group. The difference was not significant. There was no recurrence or other late complication in either groups. The result suggest that surgical excision or incision and currettage are sufficient for the treatment of regional lymphadenitis following BCG vaccination and postoperative INH therapy is not necessary.

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