• 제목/요약/키워드: Surgical result

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누두흉 치험 2예 (Surgical correction of funnel chest)

  • 한균인
    • Journal of Chest Surgery
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    • 제16권2호
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    • pp.226-230
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    • 1983
  • Two patients with funnel chest deformity were corrected at the Department of Thoracic Surgery of Chungnam National University Hospital . The first case was 11 year old boy, suffering from exertional dyspnea with asymmetrical funnel chest deformity, of which hollow cavity was measured 80 ml of water. The second case was 6 year old boy, suffering from frequent upper respiratory tract infection with symmetrical funnel chest deformity, of which hollow cavity was measured 50 ml of water. These two cases were corrected by Ravitch method, left lower lobectomy was performed concurrently on the first case. The result was satisfactory.

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Gamma-Irradiated Ultra-high Molecular Weight Polyethylene : Anisotropic Changes in Crystallinity and Crosslinking

  • Lee, Kwon-Yong
    • 대한의용생체공학회:의공학회지
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    • 제18권2호
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    • pp.107-112
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    • 1997
  • The effect of gamma-irradiation sterilization on molecular structural changes in orthopaedic surgical-grade polyethylene was studied. The relative crystallinity ud. percent crosslinking of the substance increased as a result of the gamma irradiation and varied anisotropically as a function of depth. Samples from the articulating surfaces showed 5% Venter relative crystallinity than those from the mid-sections, whereas samples from the mid-sections exhibited 15% greater crosslinking than those from the surfaces. These anisotropic variations are discussed in assDciation with oxidation.

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Do Certain Conditions Favor the Use of Autogenous Bone Graft Over Bone Substitutes for Maxillary Sinus Augmentation?

  • Lee, Ji-Hyun;Cho, Yeong-Cheol;Sung, Iel-Yong;Choi, Jong-Ho;Son, Jang-Ho
    • Journal of Korean Dental Science
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    • 제12권2호
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    • pp.48-57
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    • 2019
  • Purpose: To investigate whether there are specific surgical or clinical conditions where the use of autogenous bone (AB) is superior to the use of bone substitutes (BSs) for maxillary sinus floor augmentation (MSFA). Materials and Methods: We retrospectively analyzed 386 implants after MSFA in 178 patients. The implants were divided into five groups according to the sinus graft material used. Risk factors for implant failure in MSFA, and correlation between residual bone height (RBH) and graft materials in terms of implant survival were investigated. To investigate risk factors for implant failure in MSFA, implant survival according to graft materials, patients' sex/age, surgical site, RBH, healing period prior to prosthetic loading, staged- or simultaneous implantation with MSFA, the crown-to-implant ratio, prosthetic type, implant diameter, and opposite dentition were evaluated. Result: The cumulative 2- and 5-year survival rates of implants placed in the grafted sinus (independent of the graft material used) were 98.7% and 97.3%, respectively. None of the investigated variables were identified as significant risk factors for implant failure. There was also no statistical significance in implant survival between graft materials. Conclusion: There were no specific surgical conditions in which AB was superior to BSs in terms of implant survival after MSFA.

비골골절 시 골절정복과 동시에 시행된 융비술 (Simultaneous Augmentation Rhinoplasty with Bony Reduction in Nasal Bone Fracture)

  • 임광열;송제니퍼;김형도;황소민;정용휘;안성민
    • 대한두개안면성형외과학회지
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    • 제11권2호
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    • pp.77-84
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    • 2010
  • Purpose: The nasal bones are the most common fracture sites of the facial bones, and a careful reduction may still result in secondary deformities, such as saddle nose, deviated nose, hump nose etc, requiring secondary cosmetic rhinoplasty. Therefore, this study examined the clinical characteristics of nasal bone fractures to propose guidelines for patient selection and surgical procedures to achieve more satisfactory results and to prevent secondary deformities with simultaneous augmentation rhinoplasty and bony reduction. Methods: The study was based on 26 out of 149 nasal bone fracture patients who underwent simultaneous augmentation rhinoplasty with bony reduction between May 2008 and April 2009. Retrospective analysis was performed according to the clinical data, surgical techniques and postoperative results. Results: Of the 26 patients, there were 15 males and 11 females. The incidence according to the Stranc's classification revealed that 62% of patients were injured by a frontal impact and 38% by a lateral impact. Frontal impact plane I (50%) was the most frequent type. At the follow up, 18 (81.2%) out of 22 patients were satisfied with their postoperative outcome, and the remaining 4 patients were fair. No one was dissatisfied. However, 5 cases in 3 patients (23%) had some complications; minimal implant deviation in 2 cases, minor irregularity on the nasal dorsum in 2 cases and palpable implant movement under palpation in 1 case. None of these cases required surgical correction. Conclusion: With the proper guidance, simultaneous augmentation rhinoplasty with bony reduction can prevent secondary deformities and satisfy the cosmetic outcomes.

원인이 밝혀진 족근관 증후군의 수술적 치료의 결과 (Clinical Results of Tarsal Tunnel Decompression in Case of Known Etiology)

  • 성기선;박세준
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.192-197
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    • 2007
  • Purpose: The purpose of this study is to present our clinical results after surgical treatment in tarsal tunnel syndrome due to space occupying lesions. Material and Methods: We performed surgical decompression for tarsal tunnel syndrome in 20 patients from July 2004 to February 2007. Out of them, thirteen cases were due to space occupying lesions around the tarsal tunnel. The average age at operation was 51.3 years old and the duration from symptom onset to surgery was 16.5 months. The operation included removal of space occupying lesions and tarsal tunnel decompression. The clinical parameters were pain visual analogue scale (VAS), AOFAS scale, and subjective satisfaction. Results: The ganglion cysts were the most frequent causes (ten cases) and synovial chondromatosis in 1 case, neurofibroma in 1 case, talocalcaneal coalition in 1 case. The average follow-up duration was 14.5 months. The AOFAS scale showed significant improvement from 77.8 to 92.7. The average VAS decreased from 6.4 to 2.2. Seven out of thirteen patients were satisfied with the results. The excellent results were shown in six patients, the good results in one patient, the fair result in three patients and the unsatisfactory results in three patients. Conclusion: Favorable results could be obtained in patients with known etiology. But not all cases with surgical decompression of space occupying lesions showed satisfactory results. We assume that the clinical results were related to the multiple factors, not only well performed surgery but also age, size lesions and duration of symptoms, ect.

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피질골절단술을 이용한 상악협소증환자의 치험례 (CORTICOTOMY IN PATIENT WITH NARROW PALATAL ARCH)

  • 김은철;이상철;김여갑;류동목;이백수
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제25권4호
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    • pp.371-374
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    • 1999
  • 상악협소증으로 인하여 골격관계의 수평적인 부조화와 부정 교합을 보인 상기환자의 경우 상악확대를 위해 구개확대장치를 이용하여 치료하였으나 원하는 치료결과를 얻을 수 없었다. 방사선 평가상 안면골의 봉합부골화가 이미 끝난 것으로 보여 외과적인 피질골절단술을 시행하였다. 외과적인 피질골절단술은 상악확대시 주위안면골의 저항을 줄이기 위한 목적으로 시행하는데 좋은 결과를 얻을 수 있었다. 술후 2주경과후와 12개월 경과후 교합관계 및 확대된 상악궁의 재발상태를 평가한 결과 술후 상태로 유지되고 있었다. 전반적인 교합상태도 많이 개선되어 있었다. 그러나 피질골절단술은 사전에 악궁의 형태나 길이, 수술방법의 선택, 술후 합병증에 대한 충분한 평가를 하여야 한다. 외과적인 피질골절단술은 치료비와 치료기간을 줄일 수 있고 술후 재귀가능성을 줄일 수 있다. 이에 본과에서 피질골절단술을 이용하여 양호한 결과를 얻었기에 본 학회지에 보고하는 바이다.

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수술용 가이드와 modeless 디지털 보철물을 이용한 하악 구치부 단일 임플란트 즉시 하중 증례 (Immediate loading of mandibular single implant by using surgical guide and modeless digital prosthesis: a case report)

  • 임현정;김명주;권호범;임영준
    • 구강회복응용과학지
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    • 제33권4호
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    • pp.299-306
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    • 2017
  • 본 증례는 완전한 디지털 workflow로 단일 치아 임플란트 지지형 보철물을 즉시 부하하여 수복한 증례이다. 하악 제1대 구치 상실로 내원한 환자로, 구강 스캐너로 구내 디지털 인상채득 후, CT데이터와 디지털 스캔 데이터를 통해 제작한 수술용 가이드를 이용하여 임플란트를 식립하였다. 술 후 1주일 후, 맞춤형 지대주와 임시치아를 체결하여 즉시부하 하였다. 술 후 8주 후 지대주 레벨에서 구강스캐너를 이용하여 디지털 인상채득 후, 술 후 3개월에 지르코니아 최종 보철물을 장착하였다. 본 증례는 환자의 만족도 및 정확성 면에서 만족할 만한 결과를 나타내었으며, 완전한 디지털 과정을 통한 수복 결과 정확성, 심미성, 기능성 면에서 만족할 만한 결과를 나타내었기에 보고하는 바이다.

흉부외과 영역의 의료보험 진료수가 조정을 위한 제언 (A Proposal for an Adjustment of Fee for Medical Insurance Service in the Field of Thoracic and Cardiovascular Surgery)

  • 선경;김형묵
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.438-444
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    • 1992
  • We analysed 7,180 annual cases of surgical treatment performed by Department of Thoracic and Cardiovascular Surgery of 6 major institutes in Seoul Korea, All cases were applied to 101 of 140 coded items applicable to the field of Thoracic and Cardiovascular Surgery, in the book of "Standard Price List for Medical Service" which was notified by the Ministry of Health and Social Affairs, and of them, applied field specific items were 70 of 93 applicables. The most frequently applied items were those associated to ECC[extracorporeal circulation] 1,510 cases, and then item of closed thoracostomy 751 cases was next. Except the items associated to ECC, the coded item of the highest "Total cost[fee x total applied numbers]" was mitral valve replacement 182,356,570 won[534,770 won x 341 cases]. 140 items were arranged in "Total cost" order, and then categorized into 5 groups. Medical insurance fees of each group were modified by different grades without changes in sum of total fees. Fees of Group 1, the highest group in "Total cost" were pulled up, on the other hand, Group 4, the lowest group, were pulled down, Group 5, composed of overlapping items with other fields, were not changed. The result of adjustment by grouping showed 21.2% increment effect[535,749,105 won] in real income. And we found that new coded items for modern high technological procedures should be added to "Standard Price List for Medical Service “Standard Price List for Medical Service".

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교모세포종 환자의 여명에 관련된 인자 분석 (Analysis of Factors Affecting Survival Period in Glioblastoma)

  • 우원철;송시헌;고현송;염진영;김성호;김윤
    • Journal of Korean Neurosurgical Society
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    • 제29권11호
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    • pp.1445-1450
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    • 2000
  • Objectives : The Objective of this study was to analyze the prognostic factors affecting survival in the patients with glioblastomas. Methods : We retrospectively studied 55 consecutive patients with glioblastomas who were admitted to neurosurgery department from January 1988 to March 1998. Fifteen pateients were excluded from the analysis because of follow-up loss and surgical motality. There were 24 male and 16 female patients, with a mean age of 51 years. Surgery consisted of biopsy in 4(10.0%) patients, subtotal resection in 9(22.5%) patients and gross total resection in 27(67.5%) patients. Nine(22.5%) patients received second operation. Twenty-eight(70%) received postoperative radiation therapy. Various levels of radiation dose were used, 6,000 rad over 7 weeks in most cases. The variable factors were examined for their relationship with survival ; age at the time of diagnosis, gender, duration of neurological symptoms, preoperative neurological state(Karnofsky performance score), extent of surgical resection, location of tumor, reoperation, and postoperative radiotherapy and chemotherapy. Result : The mean survival time was 55 weeks, three(7.5%) of the 40 patients survived more than two years. Survival time with biopsy only cases was 24 weeks, for those with subtotal resection 43 weeks, and for those with gross total resection 67 weeks. A mean survival time from the time of reoperation was 42 weeks. Statistically significant survival factors in glioblastoma were extent of surgical resection, postoperative radiotherapy and reoperation. Summary : Results of our series support the views that the extent of surgery, reoperation and postoperative radiation are important prognostic factors. We also recommend radical tumor removal, postoperative radiotherapy and reoperation, if possible.

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Ischemic Complications Occurring in the Contralateral Hemisphere after Surgical Treatment of Adults with Moyamoya Disease

  • Jung, Young-Jin;Ahn, Jae-Sung;Kwon, Do-Hoon;Kwun, Byung-Duk
    • Journal of Korean Neurosurgical Society
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    • 제50권6호
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    • pp.492-496
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    • 2011
  • Objective : Direct revascularization surgery is regarded as the most effective method of treatment of adults with moyamoya disease. These patients, however, have a higher risk of perioperative ischemic complications than do patients with atherosclerotic stroke, and are at risk for ischemic complications in the hemisphere contralateral to the one operated on. We investigated the incidence and risk factors for ischemic stroke in the contralateral hemisphere after surgical treatment of adults with moyamoya disease. Methods : We retrospectively reviewed the medical records and results of neuroimaging studies on 79 hemispheres of 73 consecutive patients with adult moyamoya disease ($mean{\pm}SD$ age, $37.96{\pm}11.27$ years; range, 18-62 years) who underwent direct bypass surgery over 6 years. Results : Ischemic complications occurred in 4 of 79 (5.1%) contralateral hemispheres, one with Suzuki stage 3 and three with Suzuki stage 4. Three patients showed posterior cerebral artery (PCA) involvement by moyamoya vessels. Advanced stage of moyamoya disease (Suzuki stages 4/5/6; $p$=0.001), PCA involvement ($p$=0.001) and postoperative hypotension (mean arterial blood pressure <80% of preoperative mean arterial blood pressure) on the first ($p$<0.0001) and second ($p$=0.003) days after surgery were significantly correlated with postoperative contralateral ischemic complications. Conclusion : In patients with advanced moyamoya disease and involvement of the PCA, intentional hypotension can result in ischemic stroke in the hemisphere contralateral to the one operated on. Careful control of perioperative blood pressure is crucial for good surgical results.